Blue Shield CA Agrees to Settlement over Autism Coverage

California Insurance Commissioner Dave Jones announced today that he as reached a settlement agreement with Blue Shield of California Life & Health regarding the carrier's non-compliance with California's Mental Health Parity law.

Blue Shield of California agreed to end the dispute with the California Dept of Insurance and to cover ABA therapy (Applied Behavioral Analysis) as a life-saving medical benefit for autistic children in California.

Blue Shield of California Life & Health has agreed to cease the following practices:

*Denying ABA therapy as an uncovered service
*Challenging the medical necessity of ABA therapy
*Forcing parents into an unnecessary Independent Medical Review to secure treatment

Blue Shield has agreed to establish a dedicated customer service unit to respond to inquiries from families seeking approval for necessary ABA therapy and to pay for services at higher in-network benefit levels.

Read the CA DOI Press Release

This is very good news for Blue Shield Life & Health subscribers who have autistic children.


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