According to the suit, ABA therapy is a medically and scientifically accepted treatment that enables children with autism to increase communication, motor, and reasoning skills; enhance social functioning; decrease negative behaviors; and lead more independent lives. The U.S. Surgeon General, the National Institutes of Health, the American Academy of Pediatrics, a report commissioned by Medicare and Medicaid, and leading scholars and researchers have all found ABA therapy to be effective in treating autism spectrum disorder. The evidence also shows that denying or delaying treatment can have profound negative consequences to the children. Denial of therapy forever destroys the potential of these children to live full and independent lives.
Despite this evidence, Blue Cross characterized ABA therapy as "experimental" and refused coverage to all children with autism. It was this characterization and denial of coverage for ABA therapy that the federal court in Detroit struck down as illegal.
This ruling comes on the heels of another victory by the same law firms who litigated Berge, et al. v. United States of America, et al., Case No. 10-00373 (D.D.C., Hon. Reggie B. Walton), in which over 20,000 military families successfully sued the Department of Defense and Tricare for their denial of coverage for ABA therapy on similar grounds.
The attorneys for the Plaintiff families in Potter v. Blue Cross are:Gerard V. Mantese, Esq. Brian M. Saxe, Esq.Mantese Honigman Rossmanand Williamson, P.C.1361 E. Big Beaver Road Troy, Michigan 48083248-457-9200 Office248-515-6419 Cell email@example.com firstname.lastname@example.org John J. Conway, Esq. John J. Conway P.C.26622 Woodward Ave., Suite 225 Royal Oak, Michigan 48067313-961-6525 Office313-574-2148 Cell email@example.com SOURCE Mantese Honigman Rossman and Williamson, P.C.