I received this information from a local lawyer, who is filing class action against Blue Cross under ERISA regulations, for not covering ABA. Please see info below and contact his office if you are interested:
Dear Ms. Husband,
We have filed a class action lawsuit against Blue Cross Blue Shield of Michigan because of their denial of coverage for applied behavior analysis treatment for autistic children. Blue Cross claims that ABA treatment is experimental or investigatory, and uses this as a basis for denying coverage. Blue Cross makes this claim, despite the fact that ABA is a scientifically valid and medically accepted treatment.
We have therefore filed a class action against Blue Cross under the Federal Employee Retirement Insurance Savings Act (ERISA). One of the requirements for a class action is that the class be numerous. This means there must be a large number of people who are all similarly situated. Usually, 40 class members are sufficient to satisfy the numerosity requirement.
In our case, the class consists of:
all plan participants and beneficiaries insured under ERISA-governed employee benefit plans administered by Blue Cross and Blue Shield of Michigan who have been denied coverage for ABA treatment within the last six years.
We would like to know how many individuals meet this definition. That is, how many people have employee benefit plans administered by Blue Cross Blue Shield of Michigan, and have also been denied coverage for applied behavioral analysis treatment within the last six years.
If we can show that the class is large it will help us certify the case as a class action. Anyone who thinks that they fall within the class definition may contact:
Gerard Mantese
Mark Rossman .
David Hansma
Mantese & Rossman, P.C.
1361 East Big Beaver Rd
Troy, MI 48083
(248) 457-9200 dhansma@manteselaw.com
John J. Conway
John J. Conway, P.C.
645 Griswold St, Ste 3600
Detroit, MI
(313) 961-6525
john@johnjconway.com
Dedicated to promoting Autism Insurance in Michigan through networking and legislative reform.
AIM BIO:
AIM is comprised of over 3000 residents of Michigan who have pledged their support in passing the autism insurance legislation in Michigan. The sole aim of AIM is to pass autism insurance legislation in Michigan with the help of those 3000+ members.
AIM Position Statement
It is our position that
1) legislation should be passed in the state of Michigan that will require insurance companies to cover diagnosis, treatment, and services for all people wiht Autism Spectrum Disorders (ASD).
2) all people with ASD should be covered, regardless of age.
3) Autism Spectrum Disorder is defined as any of the pervasive developmental disorders as defined by the most recent edition of the DSM.
4) this coverage should include treatments as prescribed or ordered by the insured's treating physician or psychologist and that no insurer may deny coverage for an individual based solely on the fact that the individual is diagnosed with an ASD.
5) covered treatments shall not be subject to visit limits.
6) there should be a provision for an expedited arbitration process if an insurance company denies coverage or changes coverage status.
7) coverage should not be construed as limiting access to benefits or other services that are otherwise available to an individual.
2) all people with ASD should be covered, regardless of age.
3) Autism Spectrum Disorder is defined as any of the pervasive developmental disorders as defined by the most recent edition of the DSM.
4) this coverage should include treatments as prescribed or ordered by the insured's treating physician or psychologist and that no insurer may deny coverage for an individual based solely on the fact that the individual is diagnosed with an ASD.
5) covered treatments shall not be subject to visit limits.
6) there should be a provision for an expedited arbitration process if an insurance company denies coverage or changes coverage status.
7) coverage should not be construed as limiting access to benefits or other services that are otherwise available to an individual.
List of Supporting Organizations as of 4/23/10
ACT Network |
Ann Arbor Families for Autistic Children's Education and Support |
Autism Advisory Group
|
Autism Insurance in Michigan (AIM) |
Autism Resource Network |
Autism Society of America |
Autism Society of America - Oakland County Chapter |
Autism Society of Washtenaw County |
Autism Society of WestShore |
Autism SpeaksAutism Alliance of Michigan |
Beaumont Hospitals |
Behavior Analysts Association of Michigan
|
Detroit Medical Center
|
Early InterventionCenter |
Easter Seals |
Elder Disability Rights Association Section of the State Bar of Michigan |
Family Chiropractic Clinic |
First Capital Directories |
Forestview Lanes |
Fravel Financial Services |
GFWC Madison Heights Intermediate Womens Club |
Glenn Buege Chevrolet |
Henry Ford Health System |
HOPE Network
|
Kaufman Children's Center for Speech, Language, Sensory-Motor & Social Connections, Inc. |
Michael James Associates |
Michigan Association of Elementary and Middle School Principals |
Michigan Association of IntermediateSchool Administrators |
Michigan Association of School Administrators |
Michigan Association of School Boards |
Michigan Association of School Psychologists |
Michigan Association of School Social Workers |
Michigan Council for Maternal and Child Health |
Michigan Nurses Association |
Michigan Pharmacists Association |
Michigan PTA |
Michigan Secondary School Principals Association |
Michigan Speech Language Hearing Association |
Middle Cities Education Association |
Monroe IntermediateSchool District |
National Alliance on Mental Illness - Michigan Chapter (member of Partners for Parity) |
National Council of Jewish Women, Greater Detroit Section
|
The Abilities Center |
The Ann Arbor Center for Developmental & Behavioral Pediatrics
|
Traverse Bay Area Intermediate School District
|