NEWS for Health Care Coverage for Interventions for Children with Autism Spectrum Disorders On April 24, 2014, the California Court of Appeal issued a decision in Consumer Watchdog v. DMHC that likely expands the scope of services that certain plans are required to cover in treating autism. This opinion follows a petition of rehearing by Consumer Watchdog after the Court of Appeal unanimously decided these issues on September 10, 2013, Consumer Watchdog v. Dept of Managed Health Care, 162 Cal.Rptr.3d 85, 2014 WL 1618367 (Cal. Ct. App. Apr. 23, 2014). The case makes clear that recently-enacted legislation in California requiring coverage for Applied Behavioral Analysis (ABA) services for autism requires all health plans subject to Californias Mental Health Parity Act to cover ABA services performed by certain non-state-licensed providers, and the California Department of Managed Health Care (DMHC) cannot uphold a denial of coverage on the basis that ABA was provided by these non-state-licensed providers.
Posted on: Wed, 30 Apr 2014 16:08:22 +0000
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