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Federal Judge in Detroit Declares Case Against Blue Cross, Over Its Denial of ABA Therapy For Children with Autism, Can Proceed as Class Action

Detroit, MI. In a case brought by families having a child with autism spectrum disorder against Blue Cross Blue Shield of Michigan, Judge Stephen J. Murphy, III, today entered an Order granting Plaintiffs’ Motion for Class Certification. The families filed suit against Blue Cross over its policy of denying applied behavior analysis (ABA) therapy to children with autism. The suit alleges that Blue Cross has illegally characterized ABA therapy as “experimental,” even though it is validated by overwhelming medical and scientific authorities.
Today’s ruling means that the case will proceed on behalf of thousands of families who have Blue Cross insurance and who have a child with autism. The Order was issued in the case of Potter v. Blue Cross Blue Shield of Michigan, No. 10-cv-14981 (E.D. Mich).
ABA is a well recognized and scientifically valid form of autism treatment for children, as numerous authorities have found, including the U.S. 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.