A previous post discussed Kaiser's decision to cover ABA in Oregon. In Portland, Oregon, KATU reports:
The family of an autistic boy is taking Providence Health Insurance to federal court, claiming their son has been denied treatments guaranteed by law.
The family has filed a class-action lawsuit, saying the insurance company should pay for what's become standard but expensive treatment for autism.
Lucy Alonso's been struggling just to pay for some treatments for her son's autism, but she can't afford much.
The federal class-action lawsuit says this is just the kind of treatment federal regulations and state law require insurance companies to cover.
KGW in Portland covers the same story:
The Portland Business Journal adds some details:
The suit alleges Providence illegally excluded the ABA treatment for the plaintiffs, who are covered through family plans — a parent’s employer in A.F.’s case and a grandparents’ employer in A.P.’s case.
Both boys families paid for the treatment out of pocket but had their requests for reimbursement denied, forcing them to stop.
The verdict will be determined by a judge and not jury under federal ERISA rules. It has not yet been assigned to a judge.
The case is: A.F. through his parents and guardians, and A.P. through his parents and guardians, versus Providence Health Plan; 0:13-cv-00776.