New UnitedHealthcare settlement by Commissioner Dave Jones makes California insurance news

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Dave-Jones-Insurance-Commissioner-for-California-insuranceThe California Department of Insurance has just issued an insurance news release…

A new report explains the details of a settlement that was made between UnitedHealthcare Insurance company and Commissioner Dave Jones which requires that, beginning immediately, behavioral therapy will be covered as a medical benefit for the treatment of autism.

This new deal is only the most recent among industry wide changes that have been made to comply with the initiative that was created by Insurance Commissioner Jones. Three settlements have already been reached with other insurers earlier this year. Those other companies include Cigna, Blue Shield, and Health Net, which are all now including behavioral health treatments – such as Applied Behavior Analysis (ABA) – among the covered autism treatments.

The news release by Commissioner Jones also reconfirmed that an additional California health insurance company, Anthem Blue Cross, had already been providing this coverage since November 2009, following a direction from the Department of Insurance.

The release quoted Commissioner Jones in saying that…

“We are pleased UnitedHealthcare joins four other insurers in fulfilling its responsibility to provide this necessary and vital treatment to the state’s thousands of autistic children.” He also added that this most recent settlement will make it possible for an even larger number of families affected by autism to “have hope for a brighter future, and this latest development could not have come at a better time with April being National Autism Awareness Month.”

As an element of the arrangement, UnitedHealthcare has also said that it is willing to keep a satisfactory provider network to help the insurer to offer these treatments to all policyholders with an autism spectrum disorder, as well as to provide the treatments for the necessary length of time and frequency as indicated by the treatment provider of the policyholder.

The insurer also made insurance news by creating a customer service unit that is specifically dedicated to this part of the coverage.

The staff members in this unit will be specially trained to handle ABA-related inquiries and to provide customers with accurate information about their coverage regarding the behavioral health treatments that are medically necessary, as well as coverage for diagnosis or screening, and to confirm eligibility for coverage. These staff members will also have the authority to provide prior authorization if necessary.


Article: New UnitedHealthcare settlement by Commissioner Dave Jones makes California insurance news
Article Source: Live Insurance News California Dept of InsuranceCalifornia Insurance

Author: Colleen Jeremy


New UnitedHealthcare settlement by Commissioner Dave Jones makes California insurance news


 

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