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Tuesday, March 27, 2018

Anthem Settles Suit on Coverage Caps

The Politics of Autism includes an extensive discussion of insurance.

 Carmen Castro-Pagan reports at BNA:
Anthem Insurance Cos. Inc. will pay almost $1.63 million to end claims that it violated federal benefit laws by placing certain caps on the coverage of therapy treatments for children with severe autism disorders.
Anthem also agrees to stop using guidelines that base coverage of applied behavior analysis therapy for autism solely on an individual’s age, according to a motion seeking approval of a class action settlement filed March 23 in the U.S. District Court for the Southern District of Indiana.
Anthem joins a growing list of companies that have settled claims over coverage of ABA therapy for autism, including United Healthcare Services Inc., T-Mobile USA Inc., and Applied Materials Inc. Similar challenges against Dr Pepper Snapple, Raytheon Co., Banner Health, and Neiman Marcus Group. are pending. Late last year, a federal judge in Washington refused to dismiss similar allegations against the NECA/IBEW Family Medical Care Plan.

The case is W.P. v. Anthem Insurance Companies.