Missouri Fines Aetna $4.5M Over Autism Benefits

May 19--Aetna, one of the largest insurers in Missouri, is facing a $4.5 million fine from the state for failing to cover autism health benefits in some cases.

Governor Jay Nixon made the announcement Tuesday in Springfield.

"When an insurance company chooses to do business in our state, they agree to follow our laws," Nixon said in a press release. "These were serious violations that deserved serious punishment -- and that's what Aetna received."

In 2010, Missouri passed a law that requires insurance companies to cover the diagnosis and certain treatment autism treatments.

Aetna has agreed to pay the $4.5 million fine for not covering autism coverage in some cases, according to the statement. The Connecticut-based insurer also is at risk of losing its license to operate in Missouri for up to one year, according to the statement.

The state agency will monitor the insurer for a three-year period, if no issues arise during those three years, and the insurer complies with the agreement, Aetna will not lose its state license.

"It's a huge victory for all families with children with autism," said Dan Unumb, executive director of Autism Speaks' legal resource center.

Unumb said his advocacy organization still sees "heel dragging" on the part of insurers when it comes to offering benefits.

That's why it's so important states are "vigorous" in their enforcement, he said.

This is the second time Aetna has faced a fine for similar actions. In 2012, they hit Aetna with a $1.5 million fine for multiple infractions, one of which included not covering certain autism therapies. Aetna paid the $1.5 million, according to Chris Cline, spokesman for the Department of Insurance.

Samantha Liss -- 314-340-8017

@samanthann on Twitter

[email protected]

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