California Orders Three Insurers To Cover Speech & Occupational Therapy For Autism

On November 18, 2013, the California Department of Managed Health Care (DMHC) sent Anthem Blue Cross, Blue Shield of California, and Health Net of California cease and desist orders regarding denials of speech and occupational therapy. Some of the cases involve enrollees diagnosed with autism. DMHC took this action following receipt of 79 plan member complaints lodged since 2010 alleging that the plans denied coverage for these services without determining whether the services were medically necessary. DMHC stated that its investigation substantiated nearly all of the allegations. In addition to the order to stop denying speech and/or occupational therapy . . .