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Thursday, February 28, 2013

CA Insurers Not Following Mandate Law

Previous posts have looked at California's mandate. Alan Zarembo reports in The Los Angeles Times:
Insurers have been skirting their obligation under recently enacted state law to provide costly behavioral therapies for autism, according to the Department of Insurance, which is proposing emergency regulations aimed at enforcing the law.
In July, California joined more than two dozen other states in requiring private insurers to cover such treatments when medically necessary.
But state officials said they have received dozens of formal complaints that insurers have been delaying and denying coverage by imposing limits on how much therapy a child can receive and who can provide it, and in some cases by requiring extensive cognitive testing before treatment can begin.
The emergency regulations stipulate that those are not valid justifications for denying treatment. Officials said they planned to file the proposed rules Thursday with the state Office of Administrative Law, which will decide in March whether to put them into effect.
"Behavioral therapy is a medical treatment and has to be covered," Insurance Commissioner Dave Jones said in an interview.