Missouri Fines Aetna $4.5 Million For Violating Autism Insurance Coverage Mandate

On May 19, 2015, the Missouri Department of Insurance (DOI) announced that Aetna Life Insurance Company and Aetna Health Insurance Company (Aetna) had agreed to pay a fine of $4.5 million for violating the coverage requirements of the state’s 2010 autism insurance mandate. The mandate requires commercial insurance companies to pay for Applied Behavioral Analysis (ABA) for covered children under age 18 diagnosed with autism.

Aetna had admitted in September 2012 that on or after January 1, 2011 when the autism insurance coverage mandate went into effect, its Missouri certificates of coverage for new or renewed health plans . . .

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