Autistic parent sues California Department of Managed Health Care

Could this be a sea change?

It seems more and more folks are stepping up and calling foul on not covering needed therapies for autistic kids.

Too loud to ignore, they won't be able to do it anymore.

From the Autismeducationsite.com:

The mother of an autistic child joined Consumer Watchdog and its attorneys today to announce a lawsuit against the California Department of Managed Health Care (”DMHC”), the Schwarzenegger Administration agency responsible for regulating many of California’s health insurers. The suit alleges that the DMHC has wrongfully allowed insurance companies to refuse to pay for autism treatments, resulting in the denial of critically needed, medically necessary treatment for autistic children.

The suit, filed by Consumer Watchdog and Strumwasser & Woocher LLP, alleges that the DMHC, and its Director Cindy Ehnes, recently changed the state agency’s policy to permit insurers to deny coverage for Applied Behavioral Analysis (”ABA”), an essential treatment for autism, in plain violation of the California Mental Health Parity Act. That law requires health insurers to cover and pay for all medically necessary treatments for autism, including ABA. If successful, the suit would require the DMHC to bar insurers from refusing to cover medically necessary ABA treatments. The suit also seeks to compel the DMHC to turn over records that would expose the full extent of the DMHC’s violations of the California Mental Health Parity Act and the Knox-Keene Act.

“Californians, including those stricken by autism, and their parents and caregivers, expect regulators to enforce the law, not to side with insurance companies seeking to boost their profits by denying patients the care they need,” said Harvey Rosenfield, founder of the non-profit advocacy group Consumer Watchdog and author of the landmark insurance reform initiative Proposition 103. “Governor Schwarzenegger, a longtime and vocal supporter of the Special Olympics and developmentally disabled children, will now have to explain in court why his administration is allowing health insurers to evade state mental health laws and shift health care costs to already beleaguered taxpayers.”

Blue Cross Settles $1 million autism suit

Over 100 families to recover autism therapy fees after Blue Cross refused claims.

From Justicenewsflash.com:

Detroit, MI(JusticeNewsFlash.com)–Blue Cross Blue Shield of Michigan settled with about 100 plaintiff’s for $1 million in Detroit’s U.S. District Court regarding unpaid autism therapy. According to the Attorney General, families paid $10,000 for behavioral therapy treatments at Beaumont Hospital for their young autistic children. The parents and families of the autistic kids paid $10,000 for the specialized, needed therapy. The settlement will help families who paid for the costly treatment at Beaumont Hospital, Royal Oak, since 2003.

Blue Cross Blue Shield of Michigan will now offer the behavioral treatment for young autistic children who are covered under their parent’s group mental health policies provided by employers. The insurance coverage will be available to children between the ages of 2 and 5 years old for up to 12 weeks of treatment. This is only applicable if the parent’s employer offers mental health coverage through Blue Cross.

JusticeNewsFlash.com news for Michigan insurance litigation lawyers.

Teen commits suicide due to bullying: parents sue school

Bullying is one of my hot buttons. This is such a tragic story and frightening that this kind of bullying could happen in front of teachers without them doing anything about it.

My heart goes out to this family.

From ABC News:

Eric Mohat, 17, was harassed so mercilessly in high school that when one bully said publicly in class, "Why don't you go home and shoot yourself, no one will miss you," he did.

Now his parents, William and Janis Mohat of Mentor, Ohio, have filed a lawsuit in federal court, saying that their son endured name-calling, teasing, constant pushing and shoving and hitting in front of school officials who should have protected him.

The lawsuit -- filed March 27, alleges that the quiet but likable boy, who was involved in theater and music, was called "gay," "fag," "queer" and "homo" and often in front of his teachers. Most of the harassment took place in math class and the teacher -- an athletic coach -- was accused of failing to protect the boy.

"When you lose a child like this it destroys you in ways you can't even describe," Eric Mohat's father told ABCNews.com.

The parents aren't seeking any compensation; rather, they are asking that Mentor High School recognize their son's death as a "bullicide" and put in place what they believe is a badly needed anti-bullying program.