Here are four things to know about the settlement.
1. Under the agreement, Bloomfield, Conn.-based Cigna will lift a written ban on coverage for claims involving testing for psychiatric conditions and autism spectrum disorder. The insurer also agreed to reprocess denied claims for autism spectrum disorder and pay a $50,000 penalty.
2. Following a 2016 complaint over Cigna’s coverage ban on neuropsychological testing, the attorney general office’s healthcare bureau launched an investigation into Cigna’s mental health benefits management. The insurer’s policy previously stated “Cigna does not cover neuropsychological testing” for psychiatric conditions and autism spectrum disorder “because such testing is considered educational in nature and/or not medically necessary.”
3. The settlement requires Cigna to follow New York legislation mandating group health plans in the state provide “broad-based coverage for the diagnosis and treatment of mental, nervous or emotional disorders or ailments … at least equal to the coverage provided for other health conditions.”
4. Attorney General Schneiderman said in a statement that health insurers “must provide the same access to mental health services as they would for any other treatment. We will continue to aggressively enforce our healthcare parity laws to ensure that no New Yorker faces illegal barriers when seeking mental health treatment.”
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