|Targeted News Service|
"We are pleased UnitedHealthcare joins four other insurers in fulfilling its responsibility to provide this necessary and vital treatment to the state's thousands of autistic children" said Commissioner Jones. "This new agreement means even more families affected by autism have hope for a brighter future, and this latest development could not have come at a better time with April being National Autism Awareness Month."
As part of the settlements, UnitedHealthcare also agreed to maintain an adequate provider network to enable the company to provide treatment to all policyholders with autism; provide services for the length of time, and at the number of hours per week specified by the insured's provider; and create a dedicated customer service unit with staff who are specially trained to handle inquiries about ABA, provide information about policy benefits for medically necessary behavioral health treatment, screening or diagnosis, verify coverage or eligibility and provide prior authorization, if required. Prior to this settlement UnitedHealthcare rejected claims for ABA, saying that the treatment was experimental and investigational.
This series of agreements ensures that the company complies with the state's Mental Health Parity Act (MHP), which requires coverage for medically necessary behavioral therapies. Reinforcing the requirement of the MHP,
To further help families living with autism CDI has added a special autism page to its Department Web site (http://www.insurance.ca.gov/0100-consumers/0070-health-issues/0025-autism/index.cfm). The page offers information about services to help deal with the disorder, including: getting insurance coverage; going through the Independent Medical Review process; as well as a list of resources for family members; and a list of related organizations.
"The autism web page is an important tool the Department can offer to make the road a little smoother for
The Order to Show Cause (http://www20.insurance.ca.gov/ePubAcc/Graphics/172330.pdf) is available to the public.
TNS 23SQ120417-MJ88-3841748 StaffFurigay
|Copyright:||(c) 2012 Targeted News Service|