In Brief: Michigan Blues Ordered To Provide Autism Therapy, GERD Medications Overused
Michigan Blues Ordered To Provide Autism Therapy
A federal district court judge has ordered Blue Cross Blue Shield of Michigan to provide a form of therapy to its autistic enrollees it has claimed is experimental.
Judge Stephen J. Murphy of the U.S. District Court in Detroit ruled that the Michigan Blues' categorization of a treatment known as applied behavior analysis as experimental was arbitrary and capricious and violated the Employee Retirement Income Security Act, the federal law that governs the operation of health plans.
Regulators in California have recently ordered insurers to provide such therapy to autistic enrollees in preferred provider organization health plans.
It is unknown if the Michigan Blues plan to appeal the ruling, which was part of a class action suit undertaken by more than 500 autistic children in the state of Michigan.
GERD Medications Overused In Infants
A new study by researchers at the University of Michigan and the University of Missouri have concluded that physicians are overprescribing medications to treat gastroesophageal reflux disease in infants.
The study concluded that physicians are commonly diagnosing children under the age of 1 year as having GERD even if they exhibit common behaviors in infancy, such as spitting up. As a result, parents are asking for medication from the doctors.
"The growing digestive systems of an infant can be finicky and cause the child to regurgitate. The discomfort can cause the infant to cry, but it is not necessarily a disease," said Laura Scherer, a professor of psychological science at the University of Missouri and the author's lead study. “Parents can learn from this study that a disease label can make them want medication for their child, regardless of whether the drugs are effective or not. Parents should follow doctors' advice, which sometimes means accepting a doctor's explanation of why an infant's crying and vomiting may be normal.”
Overuse of GERD medications in infants leads to slightly higher incidents of pneumonia.
The study's findings are being published in the upcoming issue of the journal Pediatrics.
Aetna Completes Sale of Missouri Medicaid Business
Aetna has completed a deal to sell its Missouri Medicaid business to WellCare.
Aetna had about 100,000 Medicaid lives in Missouri in 54 counties, and a network of about 9,500 physicians through its Missouri Care affiliate.
Aetna sold the business to satisfy regulators as part of a separate deal to acquire Coventy Health Care. Coventry has its own Medicaid managed care plan in Missouri with about 250,000 lives.
Terms of the transaction were not disclosed.
