Michigan’s Autism Coverage Reimbursement Program
Public Act 101 of 2012 created a reimbursement program and fund. Whether it can pay depends on appropriations.
How the program works
Who can apply
A carrier includes insurers, HMOs, health care corporations and group health plan sponsors, so self-funded employers qualify as carriers. Third party administrators can apply too.
What it reimburses
Paid claims for diagnosis and treatment of autism spectrum disorders, up to the mandated amount, with an application that includes diagnostic results and claim documentation.
What it excludes
Claims for nonresidents, Medicare, Medicaid, federal programs and high-risk pools, member cost sharing, and, beginning January 1, 2014, services included in the essential health benefits.
Funding and administration
The department may not implement the program until the legislature appropriates funds, and if the fund is short, reimbursement is not made. The program moved to DIFS by Executive Reorganization Order 2013-1.
Back to the ABA guide.
Michigan’s Autism Coverage Reimbursement Program: short answers
Can a self-funded employer be reimbursed?
The Act lets a group health plan sponsor apply as a carrier, but claims for essential health benefits after 2014 are excluded and funding limits apply.
How quickly does the state decide?
The statute says an application is approved or denied within 30 days after receipt.
Is the program funded now?
Ask DIFS. The statute ties implementation to appropriations.
Michigan’s Autism Coverage Reimbursement Program: not legal advice. Send us your renewal.
Where these details come from
The laws and rules named on this page link to the official text. This is general information, not legal advice, and rules change, so check the current text.
Autism Coverage Reimbursement Act, Public Act 101 of 2012
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