Mealey's Insurance - Appeals Court: Autism Therapy Can Be Provided By Board-Certified Therapists

Mealey's Insurance - Appeals Court: Autism Therapy Can Be Provided By Board-Certified Therapists

LOS ANGELES - A divided California appeals court on April 23 reversed a trial court's decision in part and modified it to enjoin the California Department of Managed Health Care (DMHC) from upholding a plan's denial of applied behavioral analysis (ABA) therapy on the grounds that a Behavior Analyst Certification Board (BACB)-certified provider is not licensed. The court further held that even when a health plan is exempted from the ABA statute, the DMHC may not uphold a denial of coverage for ABA performed or supervised by therapists who are BACB certified on the basis the provider is not licensed (Consumer Watchdog, et al. v. Department of Managed Health Care, et al., No. B232338, Calif. App., 2nd Dist. Div. 3; 2014 Cal. App. LEXIS 352).

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