Blue Cross ordered to defend stance on autism therapy coverage

[Guest guest]

 

 

 

 

 

 

 

 

 

Monday, March 9, 2009

Blue Cross ordered to defend stance on

autism therapy coverage

Chambers / The Detroit News

DETROIT -- A U.S. District Court magistrate has ordered Blue Cross

Blue Shield of Michigan to produce documents to support its claim that a

certain type of behavioral therapy for children with autism is experimental,

and therefore ineligible for coverage.

The order, issued last week by U.S. Magistrate Hluchaniuk, states

the insurer must also produce all documents related to any studies done by

Blue Cross regarding Applied Behavior Analysis Treatment and any data

reflecting how many of its insured or their dependents have autism. The order

says the document must be filed with the court by March 25.

s, a Warren father whose 7-year-old son is autistic, is

suing the insurer because his claims for this son were denied on the basis

that such treatment is experimental. s filed the suit in federal court in

May and said he is seeking a class action because more than 7,000 children in

Michigan have autism, a neurological disorder that can cause children to

become withdrawn, nonverbal and avoid eye contact.

Data from the federal government show that one in 150 American children

has the disorder.

Officials with the insurance group have said long-term studies on autism

educational therapies have been inconclusive and the treatments are

experimental. Michigan law doesn't mandate coverage for such therapies.

Blue Cross spokeswoman Helen Stojic said Monday the insurer is very

sympathetic to the challenges of families dealing with autism.

" However, the push to expand employer insurance coverage comes at a

time when many employers are seriously struggling to pay for their existing

coverage, " Stojic said.

Attorney Mark C. Rossman, who represents s and other parents seeking

class action status, said Blue Cross has refused to produce the documents for

the last nine months.

" We asked for the documents in July. They are statistical studies on

autism and reports and studies and documents on which they base their

determination it should be excluded, " Rossman said. " It should be

interesting material, and in my opinion, it's a significant development in this

case. "

You can reach Chambers at (248) 647-7402 or jchambers@....

 

 

 

 

Find

this article at:

http://www.detnews.com/apps/pbcs.dll/article?AID=/20090309/METRO/903090407

 

 

 

 SAVE THIS | EMAIL THIS | Close 

[ ] Check the box to include the list of links

referenced in the article.

 

 

© Copyright 2008 The Detroit News. All rights reserved.

Linked from