Military families having children with autism have filed a class action lawsuit against the Department of Defense, alleging that the DoD and its health benefits division, TRICARE, have wrongfully refused to provide insurance coverage for applied beha...vior analysis (ABA) therapy. In a dramatic new development, the Department of Defense has vacated its prior policy of denying payment for ABA therapy for autistic children of military families, but it is still refusing to pay for such claims. Specifically, the DoD's attorneys have issued a policy letter stating, "The TRICARE Management Activity has vacated any previous instruction it may have issued to its contractors that ABA is not covered under the Basic Program." Military families having an autistic child should file claims for ABA therapy without delay....
The lawsuit contends that the military health benefits division, TRICARE, at the direction of the DoD, incorrectly characterizes ABA therapy as "special education" and thereby improperly excludes ABA therapy from the health care available to members of the military. The families refute this position and demonstrate in their Complaint that many prestigious individuals and organizations, including the United States Army, the Army and Marine Corps Autism Task Force, the Executive Director of the National Autism Center, the Acting Surgeon General of the United States Army, and United States Air Force Major Ella B. Kundu, Diplomate of the American Board of Psychiatry and Neurology, agree that ABA therapy is not "special education."
The case is Berge v. United States of America, et al, No. 10-cv-00373-RBW (DC), and it was assigned to Judge Reggie B. Walton of the federal district court in Washington, D.C.
Thursday, July 8, 2010
Autism and TRICARE
A press release from Mantese Honigman Rossman and Williamson: