ABA Centers of America Files Lawsuit Against Point32Health and Harvard Pilgrim

BOSTON, Jan. 7, 2025 /PRNewswire/ -- ABA Centers of America, LLC, has taken a stand against the alleged outrageous strategy used by Point32Health and Harvard Pilgrim ("Point32") to avoid paying for medically necessary treatment to help children with autism by filing a lawsuit in the Massachusetts Trial Court Superior Court of Suffolk County. The lawsuit claims that Point32 has been withholding payment for treatment plans that it authorized for more than a year, while ABA Centers of America has continued to remain committed to administering the therapy hours as prescribed. The lawsuit was filed by the Milberg law firm, a leading global class action law firm.

"We believe this lawsuit is necessary to attempt to halt the irresponsible and unreasonable behavior by Point32. We have tried for months and months to partner with Point32 in order to provide adequate care to their subscribers. We treat autism. The care we provide changes and saves lives. As the fastest growing autism care provider, we will not sit idly by and allow Point32 to continue to make decisions that negatively impact lives," remarked Christopher Barnett, Founder & Chairman of ABA Centers.

"For more than 12 months, we have continued to provide lifechanging care to clients, which Point32 has authorized, without payment. Though we still incur great expenses on a daily basis to provide this care to Point32 clients, we have received virtually no remuneration from Point32 for more than 12 months. I refuse to allow these kiddos that desperately need our care to suffer by discharging them. Instead, I will muster up my resources and hold Point32 accountable on behalf of, not only the Point32 covered kiddos in my care, but the Point32 kiddos with autism all over the country that may not have the resources which I do to fight," Mr. Barnett went on to say.

The lawsuit outlines how thousands of claims submitted by ABA Centers of America have not been denied by Point32 but have simply been placed in a "pend" status for more than a year. By essentially halting payments to ABA Centers of America, the lawsuit furthers that Point32 is attempting to put financial pressure on providers like ABA Centers of America to deter them from providing medically necessary care to children with autism. The more time, expense, and effort subscribers and providers must devote to recovering payment, the more likely they are to simply give up and absorb out-of-pocket costs. This could allow Point32 to retain premiums without providing meaningful access to the network of providers it advertised, depriving its subscribers of the services they need and deserve.

Applied behavior analysis (ABA) therapy is a medically recognized treatment service, and insurance companies are legally required to cover ABA therapy for people with autism. Point32's refusal to remit payment to ABA Centers of America threatens the lives and safety of children while stalling the progress and impact derived from receiving these services.  ABA Centers of America provides care and treatment to approximately 100 children who are beneficiaries of Point32's insurance policies.

The lawsuit claims that Point32 has what is commonly referred to as a "ghost network." By having a ghost network, in essence, Point32 forces its beneficiaries to seek out-of-network services to obtain ABA therapy. ABA Centers of America is one such out-of-network provider. Although ABA Centers does not have a contract with Point32, it authorized ABA Centers of America to provide ABA therapy to its subscribers because of its inadequate network of providers. Despite this authorization, Point32 refuses to pay for the treatment provided by ABA Centers of America. ABA Centers of America recognizes the importance of due diligence in verifying claims, however, the company asserts that Point32's practices place an unreasonable and an abnormal burden on providers and are a disservice to those in need of care.

About Christopher Barnett
Christopher Barnett was recently honored as the 2024 EY Entrepreneur Of The Year Award national overall winner, largely based upon his substantial efforts to improve the care provided to families, like his, who have a child with autism. What Mr. Barnett experienced as the parent of a child on the spectrum – the inadequacies, the lack of services available, and the long wait lists within the autism care system – were simply unacceptable. As a longtime healthcare entrepreneur, Mr. Barnett recognized that he already harnessed the infrastructure to effectuate real change within the autism care industry. With ABA Centers, he created a mission-driven organization, where every employee throughout the corporate and clinical teams is dedicated to making a lasting impact in the lives of autistic children and their families.

About ABA Centers of America
ABA Centers of America provides applied behavior analysis (ABA) therapy services to children with autism spectrum disorder through a play-based approach rooted in positive reinforcement. The company was designed to disrupt the autism care industry by demolishing wait times traditionally experienced by those in search of a diagnosis or treatment. Its strategically designed behavioral care centers offer the greatest opportunity for growth to young clients and their families. In-home and in-school therapy services are also available to deliver the most impactful continuum of care and to best meet each client's specific needs. In 2024, ABA Centers was named the No. 5 fastest growing private company in America on the Inc. 5000.

ABA Centers of America began providing ABA therapy services in Massachusetts in 2020 and currently operates seven autism care centers throughout the state, with locations in Braintree, Charlestown, Foxborough, Milford, Peabody, Wellesley Hills, and Worcester.

More information can be found at www.abacenters.com.

About Milberg
Since the firm's founding in 1965, it has repeatedly taken the lead in landmark cases that have set groundbreaking legal precedents, prompted changes in corporate governance, and recovered over 50 billion in verdicts and settlements. With 19 offices around the world, the firm pioneered federal class action litigation and is widely recognized as a leader in defending the rights of victims of corporate and other large-scale wrongdoing.  More information can be found at Homepage - Milberg | Leading Class Action Law Firm.

SOURCE ABA Centers of America