APA Practice Organization complaint leads to Cigna settlement
The APA Practice Organization scored a big win on mental health parity and other neuropsychological coverage issues. On Jan. 23, New York’s Attorney General Eric T. Schneiderman announced that Cigna be required to remove policies limiting coverage for neuropsychological testing. The decision came after the attorney general’s investigation into a complaint challenging Cigna’s national coverage policy, which excluded neuropsychological assessment for autism and certain psychiatric conditions. The complaint was filed last year by the Practice Organization, the New York State Association of Neuropsychology (NYSAN) and the Inter Organization Practice Committee (IOPC).
Under the settlement with the attorney general, Cigna is required to eliminate the exclusion for neuropsychological testing of autism and other conditions. Cigna will also reprocess denied claims for autism spectrum disorder testing from Nov. 1, 2012, and pay a penalty to the state in the amount of $50,000. The settlement also requires Cigna to clarify that it does cover neuropsychological assessment for concussion and mild cognitive impairment under certain conditions.
The Practice Organization’s Legal and Regulatory Affairs staff took the lead on the legal and contractual arguments to support assertions that Cigna’s policy violated federal and state parity laws, state law mandating coverage for autism, and coverage promises to consumers. The Practice Organization is committed to challenging insurers whose policies violate parity laws and limit your ability to practice. We encourage Practice Organization members in New York to contact our Legal and Regulatory Affairs staff if they suspect their claims are continuing to be unjustly denied by this insurer.
IOPC is a coalition of the APA Practice Organization, the American Academy of Clinical Neuropsychology, the Society for Clinical Neuropsychology/Div. 40 of the American Psychological Association, the National Academy of Neuropsychology and the American Board of Professional Neuropsychology.