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Consumer Watchdog Calls on HMO Regulator to Disclose Communications With Insurance Companies Regarding Autism Coverage Denials
Date:2/18/2009

SANTA MONICA, Calif., Feb. 18 /PRNewswire-USNewswire/ -- Consumer Watchdog called on the California Department of Managed Health Care to make public all communications between top Department officials and insurance company representatives regarding the treatment of autism. Currently, many insurers refuse to pay for treatment even though such coverage is required by law.

Download Consumer Watchdog's Public Records Act Request at: http://www.ConsumerWatchdog.org/resources/AmendedPRARequestAutism.pdf

Consumer Watchdog said the information sought by the Public Records Act request is important in light of recent statements by Department officials indicating that regulators would issue new "guidelines" that could support insurance companies that refuse to pay for autism treatment. Consumer Watchdog is concerned that the Department's position has been inappropriately influenced by insurance company executives seeking to avoid paying for autism treatment.

"Children who need treatment for autism can't afford to wait while insurance companies refuse coverage. Regulators should be working overtime to help families get the care that these kids need, not helping the insurance companies think up new excuses for denying coverage," said Jerry Flanagan of Consumer Watchdog. "Access to information concerning the public's business is an essential check against the exercise of official government power to benefit political supporters."

Governor Schwarzenegger, who appointed the current Director of the Department of Managed Health Care, has received $1,089,850 in campaign contributions from health insurance companies and HMOs.

For years insurance companies have refused to pay for autism treatments, known as Applied Behavioral Analysis (ABA), on the grounds that it was "experimental." However, that has changed in light of new research studies finding that ABA is an effective treatment for autism. In fact, the American Academy of Pediatrics said the effectiveness of ABA as a medical treatment is now considered "well documented." As a result, the state Independent Medical Review organization now commonly overturns insurance companies' denials of coverage, and requires insurers to pay for the treatments.

Consumer Watchdog is a non-profit and non-partisan consumer advocacy organization. Visit us on the web at: http://www.ConsumerWatchdog.org.


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SOURCE Consumer Watchdog
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