Washington Autism Alliance and advocacy hails United States District Judge, Honorable Robert Lasnik’s order on Friday June 1st, 2012, granting a permanent injunction against Group Health Cooperative of Washington, invalidating the long standing practice of excluding Neurodevelopmental (i.e. Speech, Occupational and Physical) therapies for children over 6 years old in their ERISA plans!
ERISA plans are those regulated by the federal government and apply to all large, self-funded, benefits that are managed by Group Health Cooperative of Washington. For far too long Health insurance carriers in Washington have been imposing very unreasonable caps, limitations and exclusions to neurodevelopmental therapies for children with conditions listed in the Diagnostic and Statistical Manual of Mental Disorders (current version DSM–IV) who are also diagnosed with autism and other developmental disabilities. In addition, the therapies were not covered at all for individuals over the age of 6, even if medically necessary.
Washington Autism Alliance & Advocacy is committed to removing barriers to insurance coverage of medically necessary treatments for autism spectrum disorders and related developmental disabilities throughout Washington state.
The court also certified the lawsuit as an injunctive relief class:
“…the Court ORDERS Defendants to immediately cease denying coverage for medically necessary neurodevelopmental therapy to treat insureds with DSM-IV-TR mental health conditions simply because an insured is over six years old. Defendants must immediately cease their application of any treatment limitations that are not generally “imposed on coverage for medical and surgical services.”
Please help distribute this press release to your networks throughout Washington State. We need your help to educate the public on their children’s right to basic healthcare for their children’s DSM conditions.