Health Net and Cigna Settle with CDI over Autism

California Insurance Commissioner Dave Jones announced today that he has reached a settlement with Health Net and Cigna regarding coverage of Applied Behavioral Analysis Therapy (ABA) for autism.

This makes three carriers who have reached settlement with the CA Dept of Insurance with regard to appropriately covering ABA and autism in California.

Last month CDI reached a settlement with Blue Shield of California to provide ABA coverage for autism. See my Jan 31 blog post: (http://an-insurance.blogspot.com/2012/01/blue-shield-ca-agrees-to-settlement.html)

Of interest is Dave Jones' comment regarding Anthem Blue Cross of California (which was not forced to settle any issues with regard to autism and ABA coverage). Per Dave Jones:

"And we are pleased to reconfirm and acknowledge Anthem Blue Cross of California for providing this treatment as the Department of Insurance has directed since November 2009."

Link to the full announcement from CDI: http://www.insurance.ca.gov/0400-news/0100-press-releases/2012/release017-12.cfm

If there any further settlements with regard to ABA therapy and autism, I will let you know in a future blog.

Dave
www.an-insurance.com

Blue Shield CA Agrees to Settlement over Autism Coverage

California Insurance Commissioner Dave Jones announced today that he as reached a settlement agreement with Blue Shield of California Life & Health regarding the carrier's non-compliance with California's Mental Health Parity law.

Blue Shield of California agreed to end the dispute with the California Dept of Insurance and to cover ABA therapy (Applied Behavioral Analysis) as a life-saving medical benefit for autistic children in California.

Blue Shield of California Life & Health has agreed to cease the following practices:

*Denying ABA therapy as an uncovered service
*Challenging the medical necessity of ABA therapy
*Forcing parents into an unnecessary Independent Medical Review to secure treatment

Blue Shield has agreed to establish a dedicated customer service unit to respond to inquiries from families seeking approval for necessary ABA therapy and to pay for services at higher in-network benefit levels.

Read the CA DOI Press Release

This is very good news for Blue Shield Life & Health subscribers who have autistic children.


Dave
Find Me Here