[Note: Shared for #AutisticHistory archive purposes. This is NOT An Autistic Ally.]
Historic’ Settlement On Autism Benefits Reached In Washington State
October 17, 2014
(October 17, 2014) — Regence Blue Shield, the largest Washington State health insurer, has agreed to settle a pair of class action lawsuits by covering medically necessary autism treatments, including applied behavior analysis (ABA), and establishing a $6 million fund to reimburse policyholders for out-of-pocket expenses incurred as a result of denied claims.
Regence is the last of Washington State’s three largest insurers to settle litigation brought under state and federal Mental Health Parity law over lack of coverage for autism treatment.
“With this settlement and the recent (state) Supreme Court decision, the standard for coverage in Washington state is clearly established,” said Eleanor Hamburger, of Sirianni Youtz Spoonemore Hamburger, who represented the plaintiffs. “All other Washington health insurers should change their policies now to ensure that children with developmental disabilities get the insurance coverage to which they are entitled.”
Hamburger was referring to a unanimous decision reached last week by the Washington State Supreme Court in a class action lawsuit that found Regence’s blanket exclusion of treatments on the basis of an autism diagnosis violated the state’s 2005 Mental Health Parity Act. Within days, Regence agreed to settle a second class action suit proceding in U.S. District Court affecting its self-insured, or so-called ERISA, plans which are regulated under federal Mental Health Parity law.
The settlement would cover both the state and federal actions and requires approval by both judges.
The proposed settlement would require coverage for medically necessary speech, occupational and physical therapies and ABA therapy to treat mental health conditions, including autism. Exclusions, age limits, monetary caps and visit limits would all be prohibited. A $6 million settlement fund would be established by Regence to reimburse policyholders whose previous claims for autism coverage were denied.
“…This proposed Settlement Agreement – now buttressed by the Washington State Supreme Court – fundamentally changes the insurance landscape for all Regence’s Washington insureds with developmental disabilities and autism,” according to a motion filed by Hamburger before the state and federal judges hearing the cases. “If approved, the Agreement would expand and align Regence’s coverage obligations with the two other large carriers in Washington (Premera and Group Health), resulting in a historic, market-wide expansion of access to medically necessary therapies in Washington State for individuals with developmental disabilities.”
Once the two judges issue their preliminary approval, final hearings will be scheduled in each court and a notice will be sent to all class members about the settlement, the final hearings, and the process for submitting claims for reimbursement of out-of-pocket neurodevelopmental therapy costs.
If the final settlement agreement is approved, Hamburger said she estimates that funds from the $6 million settlement fund could be disbursed to affected families by April or May of 2015.
In addition to the Regence, Premera Blue Cross and Group Health Cooperative actions, Hamburger has won a settlement with the Washington Health Care Authority requiring coverage for state employees and has filed an action against Boeing.
The Autism Community Is Not The Autistic Community
More With Autism Votes
Autistic people have fought the inclusion of ABA in therapy for us since before Autism Speaks, and other non-Autistic-led autism organizations, started lobbying legislation to get it covered by insurances and Medicaid.
ABA is a myth originally sold to parents that it would keep their Autistic child out of an institution. Today, parents are told that with early intervention therapy their child will either be less Autistic or no longer Autistic by elementary school, and can be mainstreamed in typical education classes. ABA is very expensive to pay out of pocket. Essentially, Autism Speaks has justified the big price tag up front will offset the overall burden on resources for an Autistic’s lifetime. The recommendation for this therapy is 40 hours a week for children and toddlers.
The original study that showed the success rate of ABA to be at 50% has never been replicated. In fact, the study of ABA by United States Department of Defense was denounced as a failure. Not just once, but multiple times. Simply stated: ABA doesn’t work. In study after repeated study: ABA (conversion therapy) doesn’t work.
What more recent studies do show: Autistics who experienced ABA therapy are at high risk to develop PTSD and other lifelong trauma-related conditions. Historically, the autism organizations promoting ABA as a cure or solution have silenced Autistic advocates’ opposition. ABA is also known as gay conversion therapy.
The ‘cure’ for Autistics not born yet is the prevention of birth.
The ‘cure’ is a choice to terminate a pregnancy based on ‘autism risk.’ The cure is abortion. This is the same ‘cure’ society has for Down Syndrome.
This is eugenics 2021. Instead of killing Autistics and disabled children in gas chambers or ‘mercy killings’ like in Aktion T4, it’ll happen at the doctor’s office, quietly, one Autistic baby at a time. Different approaches yes, but still eugenics and the extinction of an entire minority group of people.
Fact: You can’t cure Autistics from being Autistic.
Fact: You can’t recover an Autistic from being Autistic.
Fact: You can groom an Autistic to mask and hide their traits. Somewhat. … however, this comes at the expense of the Autistic child, promotes Autistic Burnout (this should not be confused with typical burnout, Autistic Burnout can kill Autistics), and places the Autistic child at high risk for PTSD and other lifelong trauma-related conditions.
[Note: Autism is NOT a disease, but a neurodevelopmental difference and disability.]
Fact: Vaccines Do Not Cause Autism.