Section 10H.5: Coverage for treatment of Down syndrome through speech therapy, occupational therapy, physical therapy and applied behavior analysis services
[ Text of section added by 2024, 388, Sec. 2 effective January 1, 2026. See 2024, 388, Sec. 7.]
Section 10H1/2. For purposes of this section, "Down syndrome'' shall mean a chromosomal condition caused by an error in cell division that results in the presence of an extra whole or partial copy of chromosome 21.
[ Second paragraph effective until August 5, 2025. For text effective August 5, 2025, see below.]
The division and its contracted health insurers, health plans, health maintenance organizations, behavioral health management firms and third-party administrators under contract to a Medicaid managed care organization or primary care clinician plan shall provide coverage for the treatment of Down syndrome through speech therapy, occupational therapy, physical therapy and applied behavior analysis services.
[ Second paragraph as amended by 2025, 14, Sec. 4 effective August 5, 2025. For text effective until August 5, 2025, see above.]
The division and its contracted health insurers, health plans, health maintenance organizations, behavioral health management firms and third-party administrators under contract to a Medicaid managed care organization or primary care clinician plan shall provide coverage for the treatment of Down syndrome through medically necessary speech therapy, occupational therapy, physical therapy and, for individuals under the age of 21, applied behavior analysis services.