Healthcare Litigation

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.

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.

Consumer Watchdog, a Santa Monica group that monitors insurance practices, has asked the court to order the Department of Managed Health Care to require insurers to provide autistic children with treatments ordered by their doctors. The group also wants the department to turn over records showing the agency's violations in this area.

LOS ANGELES, CA -- California regulators are being challenged in court for siding with insurance companies, rather than patients, over some costly autism therapies. In a lawsuit filed Tuesday, consumer advocates complain that the Department of Managed Health Care broke state law by precluding expert doctors from deciding whether an insurer must provide treatments for autism.

The non-profit Consumer Watchdog and a doctor who works with autistic children are suing the California Department of Managed Health Care. Their lawsuit alleges that the agency is allowing insurance companies to refuse to pay for effective but expensive treatments for kids with autism.

"Point of the suit is simply -- it's doctors, not insurance company bureaucrats or politicians or government lawyers, that should decide what kind of care a child could get," says Jerry Flanagan with Consumer Watchdog.

Wednesday, the group Consumer Watchdog sued the California Department of Managed Health Care, alleging the agency and its director have allowed private health insurers to refuse to provide health care to autistic children like Aidan. "The department responsible for overseeing many of the state's insurance companies has been siding with insurance companies and denying access to necessary autism care," said Jerry Flanagan, Consumer Watchdog.

Santa Monica, CA -- 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.

Consumer Watchdog filed a lawsuit Tuesday against the state agency that oversees HMOs, accusing it of violating state law by siding with insurance companies in denying treatment for children with autism. The suit accuses the department of changing its policies, forcing parents to appeal insurance denials through an internal grievance process rather than letting an independent panel of doctors make treatment decisions. "We want the department to follow the law. Doctors - not insurance companies and government lawyers - decide what care kids should get," said Jerry Flanagan, Consumer Watchdog's director of health policy.

Kaiser, Blue Cross and Other Health Insurers Illegally Deny Treatment to Autistic Children, Says Consumer Watchdog
 
Santa Monica, CA -- Parents of autistic children and their families joined Consumer Watchdog today in warning California regulators not to side with health insurance companies that are scheming to avoid paying for autism treatment that is required by state law.