Health care coverage: autism.

Senator Valladares's health care coverage legislation consolidates and reorganizes California's regulatory framework for autism treatment providers while enhancing requirements for mental health services and provider directories. The measure relocates existing definitions of qualified autism service providers from health insurance statutes to the Business and Professions Code, establishing a centralized framework for provider qualifications and oversight.

The bill's provider directory provisions mandate that health plans and insurers maintain accurate, accessible listings of in-network providers, with weekly online updates and quarterly printed directory revisions. Plans must verify provider information annually and promptly investigate reported inaccuracies within 30 business days. The legislation authorizes plans to delay payments to providers who fail to respond to verification requests after proper notice.

For mental health and substance use disorder coverage, the measure codifies requirements for medically necessary treatment under the same terms as other medical conditions. Plans must cover the full range of care levels, including residential treatment and intensive outpatient services, without limiting coverage to short-term or acute treatment. The bill maintains existing requirements for behavioral health treatment of autism, including applied behavior analysis and evidence-based intervention programs.

The legislation also expands California's mandated reporter requirements to include qualified autism service providers and professionals, adding them to the list of individuals required to report suspected child abuse or neglect. This change aligns reporting obligations with other healthcare providers and youth-serving professionals.

These provisions aim to create a more integrated regulatory structure while maintaining existing coverage mandates and consumer protections. The measure requires no new state appropriations and builds upon current oversight mechanisms within relevant state agencies.