Insurance Tactic Shot Down in L.A.

Score one for our side: A tactic used by insurance companies to deny expensive behavioral therapy to autistic children has been deemed illegal by a Los Angeles County Superior Court Judge, who has found that Kaiser Permanente’s refusal to pay for a child’s autism treatment because the provider was not licensed by the state runs counter to California’s Mental Health Parity Act.

That act requires insurers to cover care for mental and behavioral problems at the same levels they do for physical illnesses. The ruling came as part of a lawsuit filed by Consumer Watchdog, a Santa Monica advocacy organization, against the California Department of Managed Health Care to require the agency to side with consumers when insurers refuse to pay for ABA therapy. The ruling also clears the way for a trial to determine whether the department, which is responsible for regulating health plans, is doing enough to require insurers to cover such treatment. A spokeswoman for the department said the ruling would not change the way it handled disputes over autism therapy.

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Photo courtesy of Andreanna (flickr.com)

A branch of Toronto’s Hospital for Sick Children is being criticized for funding an autism conference whose organizers champion the belief that childhood immunization causes the neurological disorder. The event, slated to start Saturday at the University of Toronto, also includes presentations that some experts are calling unproven science, promoting such alternative treatments for autism as homeopathy and hyperbaric oxygen chambers. Organized by AutismOne and Autism Canada, the meeting has received $5,000 in funding from SickKids Foundation, the hospital’s fundraising wing. Blogs designed to expose practitioners of dubious science have railed against the event for the past two months. A spokeswoman for the foundation said the grant was awarded in May after Autism Canada submitted a detailed application. The Foundation also indicated that it takes a “neutral stance” on alternative and complementary health care for children, and has a history of funding it.

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