Mental Health Parity Regs in California

A release from California's Department of Insurance:

New mental health parity regulations have been approved by the Office of Administrative Law. These regulations drafted and proposed by the California Department of Insurance make sure insurance companies cover medically necessary treatment for children and individuals with autism.

"Approval of the mental health parity regulation will help end improper insurer delays and denials of medically necessary treatments for autistic individuals," said Insurance Commissioner Dave Jones. "This regulation provides clear guidance to the industry, stakeholders and consumers on the requirements of the Mental Health Parity Act from 1999."

Prior to these new regulations insurers were able to delay or deny medically necessary treatment for individuals with autism. The regulations further define the circumstances in which insurers must cover behavioral health treatments for autism. The regulations interpret and make specific the Mental Health Parity Act and gives more detailed guidance regarding the scope of the Act's provisions as they relate to autism treatment.

The Initial Statement of Reasons
Mental Health Parity Regulations

At California Healthline, David Gorn writes:

"We have all had frustration with the denials and delays," said Julie Kornack, senior public policy analyst at the Center for Autism and Related Disorders in Tarzana. "This really is making the state law and making the public policy clear."

With clear policy comes more certainty of coverage, she said. "Our hope is, [insurers] will see the laws are in place to ensure coverage."

According to advocates and officials at the Department of Insurance, delays often have come in the demand for more testing, particularly IQ testing.

"That practice creates significant delays," said Kristin Jacobson, president of Autism Deserves Equal Coverage, an advocacy group based in Burlingame. "It's an unnecessary test and it's irrelevant to needing treatment."