DOI Plans Regulations To Boost Autism Behavioral Therapy Law
On Thursday, the California Department of Insurance plans to file emergency regulations aimed at enforcing a law that requires insurers to provide behavioral therapy for autism, the Los Angeles Times reports (Zarembo, Los Angeles Times, 2/28).
In 2011, Gov. Jerry Brown (D) signed a law (SB 946) that requires all health plans as of July 1, 2012, to cover a type of behavioral therapy for autism and similar conditions. The therapy -- -- called applied behavior analysis or behavioral intervention therapy -- typically consists of intensive sessions with a therapist who uses conditioning techniques to help influence behavior.
Many insurers had previously denied coverage for the therapy, arguing that it is not a medical service and that health plans are not required to cover it by law (California Healthline, 4/18/12).
Insurers Still Not Covering Therapy, State Says
State officials say they have received numerous formal complaints that insurers have been delaying and denying coverage for the therapy by:
- Imposing limits on how much therapy a child can receive and who can provide it; and
- Requiring extensive cognitive testing before treatment can begin.
In response, officials say they plan to file proposed enforcement rules with the state Office of Administrative Law, which would decide in March whether to implement the rules.
Response From InsurersRichard Wiebe -- a spokesperson for the Association of California Life and Health Insurance Companies -- said that insurers are reviewing the proposed regulations and preparing comments. He said, "The science continues to evolve," adding, "The regulations should ... let that evolution take place" (Los Angeles Times, 2/28). This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.