ment, interventions and services for, children with 
autism spectrum disorders and adults with autism 
spectrum disorders; and 
‘‘(6) undertake any other functions that the 
Secretary determines to be appropriate. 
‘‘(c) SUPPLEMENT NOT SUPPLANT.—Amounts pro-
vided under this section shall be used to supplement, not 
supplant, amounts otherwise expended for existing net-
work or organizational structures.’’. 
SEC. 11. AMENDMENTS RELATING TO HEALTH INSURANCE. 
(a) ERISA.— 
(1) IN GENERAL.—Subpart B of part 7 of sub-
title B of title I of the Employee Retirement Income 
Security Act of 1974 (29 U.S.C. 1185 et seq.) is 
amended by adding at the end the following: 
‘‘SEC. 715. REQUIRED COVERAGE FOR AUTISM SPECTRUM 
DISORDERS. 
‘‘(a) IN GENERAL.—A group health plan, and a 
health insurance issuer providing health insurance cov-
erage in connection with a group health plan, shall provide 
coverage for the diagnosis of autism spectrum disorders 
and the treatment of autism spectrum disorders. 
‘‘(b) RULE OF CONSTRUCTION.—Nothing in this sec-
tion shall be construed— 
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‘‘(1) as preventing a group health plan or 
health insurance issuer from imposing financial re-
quirements or limits in relation to benefits for the 
diagnosis and treatment of autism spectrum dis-
orders, except that such financial requirements or 
limits for any such benefits may not be less favor-
able to the individual than such financial require-
ments or limits for substantially all other medical 
and surgical benefits covered by the plan, and there 
shall be no separate financial requirements or limits 
that are applicable only with respect to benefits for 
the diagnosis or treatment of autism spectrum dis-
orders; and 
‘‘(2) to prevent a group health plan or a health 
insurance issuer from negotiating the level and type 
of reimbursement with a provider for care provided 
in accordance with this section. 
‘‘(c) NOTICE UNDER GROUP HEALTH PLAN.—The 
imposition of the requirements of this section shall be 
treated as a material modification in the terms of the plan 
described in section 102(a)(1), for purposes of assuring 
notice of such requirements under the plan, except that 
the summary description required to be provided under the 
last sentence of section 104(b)(1) with respect to such 
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modification shall be provided not later than the earlier 
of— 
‘‘(1) 60 days after the first day of the first plan 
year in which such requirements apply; or 
‘‘(2) in the first mailing after the date of enact-
ment of the Autism Treatment Acceleration Act of 
2009 made by the plan or issuer to the participant 
or beneficiary. 
‘‘(d) PROHIBITIONS.—A group health plan, and a 
health insurance issuer offering group health insurance 
coverage in connection with a group health plan, shall 
not— 
‘‘(1) deny to an individual eligibility, or contin-
ued eligibility, to enroll or to renew coverage under 
the terms of the plan, solely for the purpose of 
avoiding the requirements of this section; or 
‘‘(2) deny coverage otherwise available under 
this section on the basis that such coverage will 
not— 
‘‘(A) develop skills or functioning; 
‘‘(B) maintain skills or functioning; 
‘‘(C) restore skills or functioning; or 
‘‘(D) prevent the loss of skills or func-
tioning. 
‘‘(e) PREEMPTION; RELATION TO STATE LAW.— 
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‘‘(1) IN
GENERAL.—Nothing in this section 
shall be construed to preempt any State law (or cost 
sharing requirements under State law) with respect 
to health insurance coverage that requires coverage 
of at least the coverage for autism spectrum dis-
orders otherwise required under this section. 
‘‘(2) EFFECT
ON
OTHER
LAWS.—Nothing in 
this section shall be construed to affect or modify 
the provisions of section 514 with respect to group 
health plans. 
‘‘(f) DEFINITIONS.—In this section: 
‘‘(1) AUTISM
SPECTRUM
DISORDERS.—The 
term ‘autism spectrum disorders’ means develop-
mental disabilities that cause substantial impair-
ments in the areas of social interaction, emotional 
regulation, communication, and the integration of 
higher-order cognitive processes and which may be 
characterized by the presence of unusual behaviors 
and interests. Such term includes autistic disorder, 
pervasive developmental disorder (not otherwise 
specified), Asperger syndrome, Retts disorder, and 
childhood disintegrative disorder. 
‘‘(2) DIAGNOSIS
OF
AUTISM
SPECTRUM
DIS-
ORDERS.—The term ‘diagnosis of autism spectrum 
disorders’ means medically necessary assessments, 
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evaluations, or tests to diagnose whether an indi-
vidual has an autism spectrum disorder. 
‘‘(3) TREATMENT OF AUTISM SPECTRUM DIS-
ORDERS.—The term ‘treatment of autism spectrum 
disorders’ means the following care prescribed, pro-
vided, or ordered for an individual diagnosed with an 
autism spectrum disorder by a physician, psycholo-
gist, or other qualified professional who determines 
the care to be medically necessary: 
‘‘(A) Medications prescribed by a physician 
and any health-related services necessary to de-
termine the need or effectiveness of the medica-
tions. 
‘‘(B) Occupational therapy, physical ther-
apy, and speech-language pathology. 
‘‘(C) Direct or consultative services pro-
vided by a psychiatrist or psychologist. 
‘‘(D) Professional, counseling, and guid-
ance services and treatment programs, includ-
ing applied behavior analysis and other struc-
tured behavioral programs. In this subpara-
graph, the term ‘applied behavior analysis’ 
means the design, implementation and evalua-
tion of environmental modifications, using be-
havioral stimuli and consequences, to produce 
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socially significant improvement in human be-
havior, including the use of direct observation, 
measurement, and functional analysis of the re-
lationship between environment and behavior. 
‘‘(E) Augmentative communication devices 
and other assistive technology devices.’’. 
(2) CLERICAL AMENDMENT.—The table of con-
tents in section 1 of the Employee Retirement In-
come Security Act of 1974 (29 U.S.C. 1001 note) is 
amended by inserting after the item relating to sec-
tion 714 the following: 
‘‘Sec. 715. Required coverage for autism spectrum disorders.’’. 
(b) PUBLIC HEALTH SERVICE ACT.— 
(1) GROUP MARKET.—Subpart 2 of part A of 
title XXVII of the Public Health Service Act (42 
U.S.C. 300gg–4 et seq.) is amended by adding at 
the end the following: 
‘‘SEC. 2708. REQUIRED COVERAGE FOR AUTISM SPECTRUM 
DISORDERS. 
‘‘(a) IN GENERAL.—A group health plan, and a 
health insurance issuer providing health insurance cov-
erage in connection with a group health plan, shall provide 
coverage for the diagnosis of autism spectrum disorders 
and the treatment of autism spectrum disorders. 
‘‘(b) RULE OF CONSTRUCTION.—Nothing in this sec-
tion shall be construed— 
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‘‘(1) IN
GENERAL.—Nothing in this section 
shall be construed to preempt any State law (or cost 
sharing requirements under State law) with respect 
to health insurance coverage that requires coverage 
of at least the coverage for autism spectrum dis-
orders otherwise required under this section. 
‘‘(2) ERISA.—Nothing in this section shall be 
construed to affect or modify the provisions of sec-
tion 514 of the Employee Income Retirement Secu-
rity Act of 1974 with respect to group health plans. 
‘‘(f) DEFINITIONS.—In this section: 
‘‘(1) AUTISM
SPECTRUM
DISORDERS.—The 
term ‘autism spectrum disorders’ means develop-
mental disabilities that cause substantial impair-
ments in the areas of social interaction, emotional 
regulation, communication, and the integration of 
higher-order cognitive processes and which may be 
characterized by the presence of unusual behaviors 
and interests. Such term includes autistic disorder, 
pervasive developmental disorder (not otherwise 
specified), and Asperger syndrome. 
‘‘(2) DIAGNOSIS
OF
AUTISM
SPECTRUM
DIS-
ORDERS.—The term ‘diagnosis of autism spectrum 
disorders’ means medically necessary assessments, 
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evaluations, or tests to diagnose whether an indi-
vidual has an autism spectrum disorder. 
‘‘(3) TREATMENT OF AUTISM SPECTRUM DIS-
ORDERS.—The term ‘treatment of autism spectrum 
disorders’ means the following care prescribed, pro-
vided, or ordered for an individual diagnosed with an 
autism spectrum disorder by a physician, psycholo-
gist, or other qualified professional who determines 
the care to be medically necessary: 
‘‘(A) Medications prescribed by a physician 
and any health-related services necessary to de-
termine the need or effectiveness of the medica-
tions. 
‘‘(B) Occupational therapy, physical ther-
apy, and speech therapy-language pathology. 
‘‘(C) Direct or consultative services pro-
vided by a psychiatrist or psychologist. 
‘‘(D) Professional, counseling, and guid-
ance services and treatment programs, includ-
ing applied behavior analysis and other struc-
tured behavioral programs. In this subpara-
graph, the term ‘applied behavior analysis’ 
means the design, implementation and evalua-
tion of environmental modifications, using be-
havioral stimuli and consequences, to produce 
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socially significant improvement in human be-
havior, including the use of direct observation, 
measurement, and functional analysis of the re-
lationship between environment and behavior. 
‘‘(E) Augmentative communication devices 
and other assistive technology devices.’’. 
(2) INDIVIDUAL MARKET.—Subpart 3 of part B 
of title XXVII of the Public Health Service Act (42 
U.S.C. 300gg–51 et seq.) is amended by adding at 
the end the following: 
‘‘SEC. 2754. REQUIRED COVERAGE FOR AUTISM SPECTRUM 
DISORDERS. 
‘‘The provisions of section 2708 shall apply to health 
insurance coverage offered by a health insurance issuer 
in the individual market in the same manner as they apply 
to health insurance coverage offered by a health insurance 
issuer in connection with a group health plan in the small 
or large group market.’’. 
(c) FEHBP.—The Director of the Office of Per-
sonnel Management shall require health benefits plans 
under chapter 89 of title 5, United States Code, to comply 
with the requirements of section 715 of Employee Retire-
ment Income Security Act of 1974, as added by subsection 
(a), insofar as such requirements apply to a group health 
plan. 
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(d) TITLE 10.—Coverage under chapter 55 of title 
10, United States Code, shall include benefits that are re-
quired to be covered by a group health plan under section 
715 of Employee Retirement Income Security Act of 1974, 
as added by subsection (a). 
(e) EFFECTIVE DATES.— 
(1) GROUP HEALTH PLANS.— 
(A) IN GENERAL.—The amendment made 
by subsections (a) and (b)(1) shall apply to 
group health plans for plan years beginning on 
or after the date of enactment of this Act. 
(B) SPECIAL RULE FOR COLLECTIVE BAR-
GAINING AGREEMENTS.—In the case of a group 
health plan maintained pursuant to one or more 
collective bargaining agreements between em-
ployee representatives and one or more employ-
ers, any plan amendment made pursuant to a 
collective bargaining agreement relating to the 
plan which amends the plan solely to conform 
to any requirement added by the amendment 
made by subsections (a) and (b)(1) shall not be 
treated as a termination of such collective bar-
gaining agreement. 
(2) INDIVIDUAL PLANS.—The amendment made 
by subsection (b)(2) shall apply with respect to 
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health insurance coverage offered, sold, issued, re-
newed, in effect, or operated in the individual mar-
ket on or after the date of enactment of this Act. 
(f) NO RELATION TO AUTISM CARE CENTERS DEM-
ONSTRATION PROJECT.—The provisions of this section 
and the amendments made by this section shall not be con-
strued to require an individual to be participating in, or 
to seek to participate in, the demonstration program under 
section 399HH of the Public Health Service Act, as added 
by section 5 of this Act, in order for such provisions to 
apply in whole or in part with respect to such individual. 
SEC. 12. AUTHORIZATION OF APPROPRIATIONS. 
There are authorized to be appropriated for fiscal 
years 2010 through 2014 such sums as may be necessary 
to carry out this Act. 
Æ 
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