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HealthCare Checkup

The Seattle Times health-care team tracks the local impact of the Affordable Care Act.

October 20, 2014 at 3:21 PM

Court, Kreidler bolster mental-health coverage

Washington residents will be able to recover some of their medical costs for certain mental health services.

Insurance Commissioner Mike Kreidler is sending letters instructing insurance companies to identify and inform policyholders whose insurance claims were denied for mental-health care that they have a right to have those claims re-evaluated, provided that they were denied under a blanket or categorical exclusion.

The letters from Kreidler are being sent in response to a ruling earlier this month by the state Supreme Court. The court determined that insurance companies are required to cover medically necessary neurodevelopmental therapies for patients with mental illness including autism. The state’s 2005 Mental Health Parity Act is the foundation for this requirement.

The coverage requirements are effective for large-employer health plans dating back to Jan. 1, 2006, and all individual and small-employer plans since Jan. 1, 2008.

More than two years ago, Kreidler began work on a rule to ensure that insurance companies were providing fair coverage of mental health care. A hearing on these rules is scheduled for Nov. 5 in Tumwater.

Comments | Topics: health insurance, Mike Kreidler

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