California families denied coverage by Kaiser Permanente for applied behavior analysis (ABA) and speech therapy for their children with autism between 2004 and 2012 can apply for up to $9.3 million reimbursement for their out-of-pocket expenses and debts, under a class action lawsuit settlement.
Kaiser agreed to set up the fund to settle the lawsuit, which was brought in state Superior Court on behalf of Andrew Arce of Los Angeles who was 2 years old when Kaiser denied claims for his ABA treatment. The settlement covers out-of-pocket expenses and debts incurred between April 8, 2004 and June 30, 2012 for children diagnosed with autism.
The lawsuit alleged that Kaiser improperly denied coverage for ABA and speech therapy for children with autism under the terms of its contracts and the California Mental Health Parity Act. The class action is one of several filed around the nation charging health plans with violating state mental health parity laws by denying claims on the basis of an autism diagnosis.
An explanation of the settlement is here
A copy of the claim form is here