Anthem, Blue Shield to Cover Therapy for Children with Autism

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[Source: LA Times]

Two of California’s largest health insurers have agreed to pay for costly behavioral therapy for thousands of autistic children — services the companies have long resisted covering.

Under pressure from regulators, Blue Shield of California and Anthem Blue Cross said they would pick up the initial cost of a treatment known as applied behavior analysis.

Insurers, worried about rising demand for expensive services as the number of autism cases grows, have argued that the therapy is not a medical treatment but an educational or social service exempt from coverage.

Anthem and Blue Shield settled their dispute with the California Department of Managed Health Care to avoid penalties or other enforcement actions, officials said. The companies agreed to the settlements but acknowledged no wrongdoing.

Both insurers have agreed to cover a minimum of six months of treatment for HMO patients as long as the services are deemed “medically necessary” by healthcare providers and offered under the supervision of licensed professionals.

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2 Responses to Anthem, Blue Shield to Cover Therapy for Children with Autism

  1. Alexia Dorsa says:

    The problem is that there are no “licensed” behavioral therapists in CA. So where does that leave parents?

  2. jenn says:

    Blue cross blue shield of Texas covers all aba therapy at 100%. It is the law in Texas. Parents need to fight that 6mos baloney.