Friday, February 27, 2009

Michigan autism insurance coverage case gets closer to class-action status

From the Detroit News:

DETROIT -- A federal court judge was poised Feb. 26 to grant class-action status to a lawsuit by parents of autistic children who want Blue Cross-Blue Shield of Michigan to pay for behavioral therapy, but agreed to give the insurer more time to file a response in the case.

U.S. District Judge Stephen Murphy told Blue Cross attorney Scott Hamilton that because there was no response from Blue Cross on the record as to why he should oppose class certification, he was willing to grant the motion. But because he was impressed with Hamilton's earlier arguments, he would allow the attorney time to file a response.

"Otherwise I will grant that motion as unopposed," Murphy said.

Christopher Johns, a Warren father whose 7-year-old son is autistic, is suing Blue Cross on behalf of people who have been denied claims on the basis that applied behavioral analysis treatment for their autistic child is experimental. Johns filed the suit in federal court in May and 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because more than 7,000 children in Michigan have autism, a neurological disorder that can cause children to become withdrawn, nonverbal and avoid eye contact.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 shows that 1 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.

"Time is a real factor, in this case," said Gerard Mantese, Johns' lawyer. "Children with autism who are between 2 and 7 can make great progress with these programs. We want to move forward as fast as we can."

There's no cure for autism, but research shows that early intervention through intensive therapies and other services can improve development, according to the U.S. Centers for Disease Control and Prevention.