Insurer Settles Lawsuit Over Denied ABA Therapy

african american girl concentrating on her schoolwork, paintings in the background

by Andy Jones
March 19, 2017

A federal court has signed off on a settlement with disability advocates in Oregon and Providence Health Care, ending a long-running dispute over its coverage of applied behavioral therapy, the primary treatment for young children with autism.
In August 2014, the U.S. District Court for the District of Oregon ruled that the insurer could not deny coverage of ABA therapy without running afoul of federal mental health parity laws, which require insurers to provide coverage to people with mental and intellectual disabilities equal to that of their coverage for physical disabilities.

The class-action represented more than 40 families whose children had been denied treatment, according to the Oregonian. Disability Rights Oregon wrote an amicus brief in support of the plaintiffs in the lawsuit.

Under the settlement, Providence Health Care agreed to cease denying coverage for ABA therapy, which for families without insurance can cost up to $50,000 a year. It will also pay $10,000 each to the two families who brought the lawsuit.

The court previously granted a motion by five families against the insurer to recover out-of-pocket expenses for treatment purchased after being denied ABA therapy by Providence Health Care.

Disability Rights Washington and Disability Rights Oregon are the designated protection and advocacy agencies in Washington and Oregon, respectively, and are members of the National Disability Rights Network.