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Aetna Must Rethink Wilderness Therapy, Boarding School Coverage

Nov. 2, 2020, 8:29 PM

A Lockheed Martin Corp. employee won a federal court order requiring Aetna Health & Life Insurance Co. to reconsider its decision denying coverage for his son’s treatment at a Utah wilderness therapy program and a therapeutic boarding school for adolescents with behavioral issues.

Aetna’s denial of coverage based on the family’s failure to obtain precertification for the boy’s treatment is “impossible to defend” based on the language in Lockheed’s health plan, Judge David Barlow of the U.S. District Court for the District of Utah ruled Oct. 30.

“Although the Plan requires precertification for these services, it also provides a specific...

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