Blue Shield of California Life & Health Insurance Co. agreed this week to immediately cover the cost of applied behavior analysis (ABA) therapy for autism patients. This decision was the result of a settlement with state regulators, stemming from a dispute this past July when California Insurance Commissioner Dave Jones filed an enforcement action against Blue Shield. “This favorable settlement agreement eliminates the frustration and insecurity so many families have faced when seeking autism treatment for their children,” Jones said in a statement.
Blue Shield actually already began paying for ABA therapy for members enrolled in plans regulated by the Insurance Department in July. They were the first insurer to do so for members with autism. New legislation, which takes effect July 1, 2012, requires that health care plan contracts and health insurance policies to give coverage for behavior health treatment for autism and pervasive developmental disorder, as stated in law SB 946.
In the meantime, Commissioner Jones will continue to require health insurers to provide coverage such as ABA therapy to patients with autism who seek it prior to the effective date of the new law.
Source: LA Times