Healthcare Litigation Archives

Autism Treatment Claims Dispute Can Go To Trial

October 27, 2009 · Consumer Watchdog

A lawsuit seeking health care coverage for the use of applied behavioral analysis in the treatment of autism has been cleared for trial by the Los Angeles County Superior Court. Consumer Watchdog et. al. vs. California Department of Managed Health Care et. al. involves Kaiser Permanente’s denial of coverage for a child’s ABA treatment because the provider wasn’t licensed by the state. The Oakland, Calif.-based health maintenance organization cited regulations issued by the California Department of Managed Health Care as its reason for denying coverage for ABA treatment.

Judge To Schwarzenegger Administration: Autism Denials Illegal

October 27, 2009 · Consumer Watchdog

Santa Monica, CA – A Los Angeles County Superior Court judge issued a ruling finding that the Schwarzenegger Administration has illegally sided with health insurance companies that deny access to care for autistic children. A memo circulated by the Schwarzenegger Administration to health insurers was also ruled to be an illegal “underground regulation” because it violated state law requiring a public process for changing insurance regulations.

Ruling Deals A Blow To Denials Of Autism Treatment

October 27, 2009 · Consumer Watchdog

Refusing to cover a costly behavioral therapy because the care provider lacks a state license violates California law, a Los Angeles County judge finds. Consumer Watchdog President Jamie Court said the ruling was reason enough for Gov. Arnold Schwarzenegger to order the department to stop fighting the suit and start ordering insurers to provide the treatment to their autistic members. "For an administration that is so involved with the Special Olympics to not understand the harm it's causing every day that an autistic child doesn't get the care they need, is not only legally inexcusable, but morally reprehensible," Court said.

California Sued Over Regulation of Autism Treatments

July 8, 2009 · Consumer Watchdog

The lawsuit, filed by Consumer Watchdog in Los Angeles Superior Court, claims DMHC has permitted the denial of "critically needed, medically necessary" treatments. The advocacy group alleged Department Director Cindy Ehnes illegally permitted insurers to deny coverage for Applied Behavioral Analysis, a common autism treatment, in violation of the California Mental Health Parity Act. Also, DMHC improperly withheld public documents requested by Consumer Watchdog, it claims.

Suit Alleges California Lets Insurers Deny Treatment For Autistic Kids

July 2, 2009 · Consumer Watchdog

A nonprofit consumer group has filed a lawsuit against state regulators alleging they allow insurance companies to deny necessary but expensive treatment for autistic children in violation of state law. Santa Monica-based Consumer Watchdog filed the lawsuit against the California Department of Managed Health Care Tuesday in Los Angeles Superior Court.

Autism Patients’ Treatment Is Denied Illegally, Group Says

July 2, 2009 · Consumer Watchdog

Consumer Watchdog asks a judge to order the state Department of Managed Health Care to enforce the law and require insurers to serve autistic members. The agency says it's doing its job. "Californians, including those stricken with 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 nonprofit Consumer Watchdog and author of the landmark automobile insurance reform initiative Proposition 103.