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Monday, October 20, 2014

A Settlement in Washington State

Annie Zak reported last week at the Puget Sound Business Journal that Regence BlueShield, the largest health insurer in Washington state, settled two class-action lawsuits the previous for $6 million over its lack of coverage of ABA.
The suits, filed in federal district court and King County Superior Court by the families of children with autism, makes Regence the final health insurer among the state's three largest to get taken to court over their lack of coverage for such disabilities.The other two – Premera Blue Cross and Group Health Cooperative — also settled their cases.
According to the advocacy group Autism Speaks, Washington is one of 16 statest hat does not require insurance companies to cover behavioral treatments.
Eleanor Hamburger, an attorney with the plaintiffs' law firm Sirianni Youtz Spoonemoore Hamburger, said she believes one reason these therapies have been neglected by many insurance companies
"A lot of these plans had an exclusion of developmental disability services, and I think this stems from this historical perspective on people with disabilities, that they can't be cured," Hamburger said. "Research has shown that interventions on people with developmental disabilities have a big impact on their lives."
Another reason contributing to the previous lack of coverage is that the Washington state's 2005 Mental Health Parity Act, while mandating coverage for mental health services, said neurodevelopmental therapies may constitute mental health services if they are "medically necessary," according to the lawsuit. That provision meant some insurers could choose not to include autism and other neurodevelopmental treatment.
Part of that $6 million will be used to create a fund for those involved in the class action suit who paid for their own treatments during the period of the lawsuits.