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California insurers agree to cover cost of autism treatment Posted: July 18th, 2011

By Maryalene LaPonsie

Saying it was "perplexed" by an enforcement order sent by the state, Blue Shield of California has announced it will provide temporary coverage for Applied Behavioral Analysis (ABA), an autism therapy. The California Department of Insurance (CDI) sent an Order to Show Cause to the health insurance company last week after its denial of ABA coverage for two autistic children.

However, in a statement, Blue Shield of California asserts it had already agreed to provide coverage for the two children in question. In addition, the insurer says it will provide ABA coverage until the courts are able to settle a dispute involving the legal interpretation of the California Mental Health Parity Law. The CDI claims ABA is a medically necessary treatment that must be covered under the statute.

In reaching a settlement with the Department of Managed Health Care, Blue Shield of California agreed to extend ABA coverage to all its members. The insurance company will pay for services provided by licensed practitioners or those working under the supervision of a licensed practitioner, but will not pay for services performed by unlicensed individuals.

According to the Los Angeles Times, Anthem Blue Cross has also agreed to provide coverage for ABA therapy.