October 20, 2009

Preliminary Ruling in Consumer Watchdog v. California Department of Managed Health

The decision by the Superior Court of California, County of Los Angeles, clears the way for a lawsuit, Consumer Watchdog v. California Department of Managed Health, to go to trial to challenge whether the California Department of Managed Health Care is doing enough to require insurers to cover autism treatment services. The decision centered on whether insurers could refuse coverage for autism therapy services if the service providers were not licensed by the state. The state's Mental Health Parity Act requires that a health plan offer mental health services on the same conditions as services for physical conditions; however there is no requirement that health care providers be licensed or certified unless the law requires licensure or certification. Applied behavioral analysis services are typically provided by professionals who are not licensed or certified in or by the State of California.