California Court of Appeal

The trial court's judgment denying plaintiff's petition for a writ of mandate to direct defendant to order health plans to cover Applied Behavioral Analysis (ABA) therapy provided by Behavior Analyst Certification Board (BACB)-certified therapist to treat autism, is reversed and modified to enjoin defendant from upholding a plan's denial of ABA services where the basis for the denial is that a BACB-certified provider is not licensed, because: 1) a statute recently enacted by the Legislature authorizes BACB-certified providers to perform ABA therapy under state licensing laws; 2) therefore, defendant can no longer uphold a plan's denial of coverage on the basis that a BACB-certified provider is not licensed; and 3) the trial court correctly resolved plaintiff's challenge to defendant's policy as violative of the Administrative Procedures Act. (Opinion on Rehearing)

Appellate Information

• Decided 04/23/2014
• Published 04/23/2014

Judges

• KITCHING

Court

• California Court of Appeal

Counsel