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Tuesday, June 19, 2012

Implementing the California Mandate

Previous posts have discussed the California insurance mandate. Laura Shumaker writes at the San Francisco Chronicle:
Insurance companies have perfected some quietly time-tested methods. They know that if virtually 100% of their subscribers whose children receive an ASD diagnosis come to them requesting therapy. if they refuse them all, only about 10% will come back and challenge that refusal. The rest will go away. Be the 10%! You will navigate the refusals, the requests for further information, the redirection and the misdirection. You will not be alone as you make this journey. For specific information on how to begin the process of requesting insurance coverage for autism therapy (and a peek at the obstacles you are likely to encounter) attend an upcoming insurance lecture in your area or visit Check out or better yet talk to other fellow parents., join an insurance users group Kaiser Members & All other Health Plans One caveat – this law does not apply to health care plans that do not deliver mental health or behavioral health services to enrollees, or to participants in the Medi-Cal program. While the Healthy Families Program and California Public Employees Retirement System (CalPERS) are explicitly excluded from the law, they are not exempt from the existing Mental Health Parity law (AB 88). According to a recently published survey by the Autism Society of California, when families were asked,  “Do you plan on accessing benefits through the new autism health care law? “ almost half (44%) answered, “What health care law?”