Cigna changes its national policy for neuropsychological testing

The new policy covers testing for some previously excluded conditions.

Major health insurer Cigna has changed its national policy on neuropsychological testing following New York Attorney General Eric T. Schneiderman’s settlement with Cigna to remove blanket limitations on coverage for neuropsychological testing in New York.

Cigna’s new national policy eliminates the prior exclusions for: “psychiatric disorders,” autism spectrum disorders, pervasive development disorders, concussion and mild cognitive impairment.

The policy change and the decision from the New York attorney general were the result of the Practice Organization’s advocacy efforts. Prior settlements with the New York attorney general have caused other insurance companies to change their behavior nationally. The Practice Organization is happy to see that this settlement continues that trend to the benefit of neuropsychologists and their patients nationwide.

Katherine C. Nordal, PhD, the Practice Organization’s executive director for professional practice, praised Schneiderman for his outstanding leadership on this and other parity and insurance issues.

“This Cigna settlement is an important victory for patients and consumers in New York and nationwide, as well as for the psychologists who treat them,” Nordal says.

Background on New York victory

The attorney general’s settlement with Cigna in January resulted from his office investigating a complaint that the Practice Organization filed last April with the New York State Association of Neuropsychology and the Inter Organizational Practice Committee.1 The Practice Organization’s Office of Legal and Regulatory Affairs took the lead on legal and contractual arguments alleging that Cigna’s exclusions violated state and federal parity laws, New York law mandating autism coverage, and reasonable consumer expectations of coverage. Schneiderman agreed.

The New York attorney general’s settlement required Cigna to change its neuropsychological coverage policy, pay a $50,000 fine and repay denied autism claims in New York dating back to 2012. Further details on the settlement, and the advocacy leading up to it, are in a prior announcement on APA Practice Central’s website.

1 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.