P.R. Laws tit. 24, § 3573
Health insurance plans, whether through individual or group coverage, insurance company, contract or agreement to provide healthcare services in Puerto Rico entered into with companies, individuals or local or foreign entities, shall be required to offer coverage for Autism treatment. Said coverage shall include, but not be limited to, genetics, neurology, immunology, gastroenterology, and nutrition, as well as speech and language, psychological, occupational, and physical therapy including medical appointments and any medically recommended tests.
Said coverage shall not establish patient age limitations. It shall neither be subject to limitation with regard to benefits and a maximum number of healthcare professional appointments, after care needs have been established by a licensed physician.
The coverage herein established may be subject to the same copayments and deductibles to which other similar services are subject.
No insurer, benefit provider, benefit administrator, person, or institution may deny or refuse to provide covered services based on the effect that the inclusion of said services may have on the Autism coverage; or refuse to renew, issue or restrict or cancel the Autism coverage because the covered person or his/he dependents are diagnosed with Autism or because they availed themselves of the benefits provided in this chapter.
Any insurer shall be required to submit quarterly reports to the Department of Health on the number of insured persons who have been diagnosed with autism spectrum disorder.
The cancellation of an existing healthcare insurance policy by reason of a diagnosis of autism spectrum disorder of one of the beneficiaries when the illness was unknown at the time said policy was obtained is hereby prohibited.
History —Sep. 4, 2012, No. 220, § 15.