Parents of autistic kids seek class-action status against Blue Cross

by Jennifer Chambers / The Detroit News

DETROIT -- A federal court judge will issue a written opinion on whether parents of autistic children who want Blue Cross-Blue Shield of Michigan to pay for behavioral therapy have viable claims and whether their case should proceed as a class action lawsuit against the insurer.

Christopher Johns, a Warren father whose 7-year-old son is autistic, wants certification of a class of people who have been denied claims on the basis that treatment is experimental. Johns filed the suit in federal court in May 2008 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because more than 7,000 children in Michigan have autism, a neurological disorder that can cause children to become withdrawn, and nonverbal, and avoid eye contact.

Data from the federal government shows 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.

U.S. District Court Judge Stephen Murphy heard arguments Thursday from Blue Cross on why the case should be dismissed and from Johns attorneys on why it should proceed.

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

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.

In the lawsuit, Johns says applied behavioral analysis has scientifically documented results that ABA therapy is effective in treating autism.

In the suit, Johns cites two programs by Beaumont Hospital that provide ABA therapy, the GIFT of Hope program and the CARE program, which are supervised by licensed psychologists on site.

The GIFT program allows parents of autistic children to participate in the treatment of their children with the goal of teaching parents to apply ABA techniques on a day-to-day basis. In the CARE program, individual treatments focus on communication, social interaction, play, self-help and pre-academic skills, as well as reducing problematic behavior.

The lawsuit is seeking damages and an injunction requiring Blue Cross to provide coverage for future treatments.

Source: http://www.detnews.com/apps/pbcs.dll...902260464/1361

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