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Cigna reaches settlement, will pay penalty over psych test policy

Insurer ordered to pay $50,000, revise its policies and pay autism claims previously rejected, says New York attorney general.

Susan Morse, Senior Editor

Cigna has reached a settlement with the New York Attorney General's Office that requires the health insurer to eliminate a written ban on mental health coverage.

Cigna must revise its policies, pay autism claims previously rejected, and pay a penalty of $50,000, the AG's office said.

The settlement regards coverage for neuropsychological testing of psychiatric conditions and autism spectrum disorder.  Cigna will also reprocess denied claims for autism spectrum disorder, according to Attorney General Eric T. Schneiderman.

"Insurers must provide the same access to mental health services as they would for any other treatment," Schneiderman said.

[Also: Anthem extends termination date of deal with Cigna to April 30]

Schneiderman's Health Care Bureau launched an investigation after receiving a complaint in 2016 about Cigna's mental health benefits.

The insurer had a written policy that said, "Cigna does not cover neuropsychological testing because such testing is considered educational in nature and/or not medically necessary."

Under the terms of the settlement, the company agreed to comply with Timothy's Law, New York legislation enacted in 2006 after a 13-year-old Schenectady boy committed suicide. The insurance company had denied him ongoing coverage for treatment of serious mental health issues, the AG's office said.

New York group health plans have since been mandated to provide broad-based coverage for the diagnosis and treatment of mental, nervous or emotional disorders or ailments.

The New York law is similar to federal mental health parity laws  passed in 2008 that require coverage be at least equal to that of  other health conditions.

Cigna has also agreed to clarified its policy regarding concussion and mild cognitive impairment, according to the AG's office.

The insurer will provide coverage information to its members and members' healthcare providers upon request.

Twitter: @SusanJMorse

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