Blue Cross agrees to $1 million settlement of lawsuit over denied claims
Blue Cross Blue Shield

According to the reports from the Detroit News and the Detroit Free Press, Blue Cross Blue Shield of Michigan has decided to settle the lawsuit filed against it by families of young children with autism who were denied coverage for certain behavioral therapies, by providing an estimated $1 million in reimbursements to around 100 families.

The suit was filed in US District Court in Detroit in May last year. Initiated by Christopher Johns, a Warren man who has a 7-year-old autistic son, the lawsuit was filed by Attorney Gerard Mantese on behalf of people who were denied claims by the nonprofit insurance company, which said that that ‘applied behavioral analysis therapy’ for the neurological disorder is experimental.

As per the ruling by the Federal District Court Judge Stephen J. Murphy III, Blue Cross will reimburse all autistic therapy cases covered under its insurance since May 1, 2003.

Saying that he was “very happy for the families,” Mantese added: “This is a landmark settlement. It not only makes it clear that autistic children should not be denied this therapy in Michigan but it moves the whole issue forward nationally. The result here in Michigan is going to make it more and more difficult for insurance companies in other states to try to cut costs by denying critical care to children who really need it.”
 

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