The Department of Managed Health Care declines to require carriers to pay for applied behavior analysis, an expensive therapy that insurers contend is an educational service, not medicine.By Lisa Girion
March 10, 2009
California regulators said Monday that insurers must provide speech, occupational and physical therapies to their autistic members but rejected pleas to require insurers to cover the cost of behavior therapy that aims to help patients live in society.
At issue is so-called applied behavior analysis, a therapy that teaches patients skills such as self-feeding and stopping injurious behaviors such as head banging. The therapy can cost as much as $70,000 a year per patient.
Parents of children with autism have argued in lawsuits and in complaints to regulators that insurers, by refusing to pay for an array of autism care, are ignoring the Mental Health Parity Act. The 2000 state law requires insurers to treat mental conditions the same as medical conditions.
Yes, being able to feed oneself and avoiding banging one's head against the wall are hardly medical issues, are they? At least not in the eyes of private health insurance companies. The best way to reform health care is to put those who stand in the way of people getting it out of business.
Can we talk? (about Israel's oppressive polices?) It's looking better all the time. Glenn Greenwald reports on the latest, including Roger Cohen's strong criticisms of the Jewish state.