LANSING, Mich., Aug. 9, 2011 /PRNewswire/ -- In a case filed on behalf of schoolteachers having a child with autism against Blue Cross Blue Shield of Michigan, the Circuit Court in Ingham County ruled that the case may be expanded to include families who never made a claim for coverage for applied behavior analysis (ABA) therapy, in light of Blue Cross' policy not to honor such claims. The suit alleges that Blue Cross' policy of denying coverage for ABA therapy, on the ground it is "experimental," is arbitrary and contradicted by overwhelming medical and scientific authorities.
Under the Court's ruling, all MESSA insureds who have a child with autism may seek relief against Blue Cross over its policy of denying ABA therapy, whether or not the family made a formal claim with Blue Cross. The ruling was made in the case of Barkowska v. Blue Cross Blue Shield of Michigan, No. 10-1001482-CK-30 (Ingham County Circuit Court, Hon. Clinton Canady, III).
Numerous authorities have long found that ABA is a scientifically valid treatment for children with autism, including the United States Surgeon General, the National Institute of Mental Health, the American Academy of Pediatrics, and a study commissioned for both the Medicare and Medicaid systems. Moreover, 26 states mandate insurance coverage for ABA therapy. Yet, despite settling a class action last year on this same issue, and paying approximately one million dollars in benefits, Blue Cross Blue Shield of Michigan persists in denying coverage for ABA therapy on the ground that it is "experimental."
Studies show that providing ABA therapy to children with autism allows them to achieve their maximum potential and greater independence in their adult lives.
The families are represented by Gerard Mantese and John Conway, whose contact information follows:
Gerard Mantese, Esq.
Mantese Honigman Rossman and Williamson, P.C.
1361 E. Big Beaver Road
Troy, Michigan 48083
John J. Conway, Esq.
John J. Conway, P.C.
26622 Woodward Avenue, Suite 225
Royal Oak, MI 48067
SOURCE Mantese Honigman Rossman and Williamson, P.C.