P.R. Laws tit. 24, § 3572

2019-02-20 00:00:00+00
§ 3572. Healthcare service coverage

Autism spectrum disorder is hereby recognized as a health disorder. Autism spectrum disorder is a neurodevelopmental disorder that, in addition to social interaction and communication impairments caused by neurological problems, entails metabolic, immunological, and gastrointestinal conditions. Moreover, it requires speech and language, psychological, occupational, and physical therapy, as well as the proper medication and tests to diagnose and treat the same. The Puerto Rico Health Insurance Administration (ASES, Spanish acronym) shall establish for any eligible beneficiaries of the Government of Puerto Rico Health Insurance Plan, as part of the minimum coverage and benefits provided in § 7032 of this title, known as the “Puerto Rico Health Insurance Administration Act”, such medical treatments that have been scientifically proven effective and are recommended for the autism spectrum disorder population, according to the available resources and the specific needs of patients. ASES shall ensure that contracted health insurance companies include within their coverage, services geared to the diagnosis and treatment of persons with autism spectrum disorder, namely: 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.

Furthermore, the Administration shall advise families of persons with autism spectrum disorder on learning about the proper intervention strategies.

ASES shall have thirty (30) days after the Autism diagnosis to refer a patient to the pediatric center of the region where said patient or his/her family or guardian lives so that said patient can receive specialized treatment as warranted by the condition.

History —Sep. 4, 2012, No. 220, § 14.