Relevant Issues: Child with autism is on a waiting list for ABA therapy funded by Medicaid (using a medicaid waiver).
Status: Child with autism is on a waiting list for ABA therapy funded by Medicaid (using a medicaid waiver).
Relevant Issues: Child with autism is on a waiting list for ABA therapy funded by Medicaid (using a medicaid waiver). Defendent uses AHCA to argue that ABA is experimental.
Status: The court ordered the State of Florida to provide, fund, and athorize ABA for all medicaid-eligible persons under age 21 who are diagnosed with ASD
Relevant Issues: Plaintiffs argue that Defendent violated Medicaid act by denying ABA for ASD and they won. This appeal lays out the scope of the permanent injunction and declaratory judgment.
Status: The court asks the lower court to modify the judgment to read: “…the State of Florida is hereby ordered to provide, fund, and authorize Applied Behavioral Analysis treatment to Plaintiffs K.G., I.D., and C.C.[2]
. . . .” and “…Defendant shall take whatever additional steps are necessary for the immediate and orderly administration of ABA treatment to Plaintiffs K.G., I.D., and C.C.[3]”
Relevant Issues: A continuation of the original case where Plaintiffs argue that Defendent violated Medicaid act by denying ABA for ASD and they won. The above appeal lays out the scope of the permanent injunction and declaratory judgment. This case determines attorney fees.
Status: The court awards attorney fees to plaintiffs.
Relevant Issues: A child with autism required ABA as a necessary treatment, but the Ohio’s Help Me Grow program does not provide it. The plaintiffs allege claims under the IDEA, the Rehabilitation Act and the ADA.
Status: The defendants’ motion to dismiss was granted due to the argument that the plaintiffs have not properly exhausted their administrative remedies.
Relevant Issues: A child with autism required ABA as a necessary treatment, but the Ohio’s Help Me Grow program does not provide it. The plaintiffs allege claims under the IDEA, the Rehabilitation Act and the ADA.
Status: The Court of Appeals agrees with the lower court that the Plaintiffs have not exhausted the administrative remedies under the IDEA.
Relevant Issues: Plaintiff requested a preliminary injunction compelling defendants to provide MM with 40 hours per week of applied behavioral analysis (“ABA”) services or, alternatively, compelling defendants to reimburse plaintiff for providing these services
Status: Plaintiff’s motion was granted in its entirety.
Relevant Issues: The state failed to provide a child with autism request appropriate services (not ABA) and parents want reimbursement for ABA. The state claimed that the providers were unqualified and therefore, refused to reimburse parents.
Status: This Court affirms that “when states fail to deliver appropriate services due to a shortage of providers who have been licensed or certified by the state, strict adherence to the statute’s requirement that qualified (i.e., licensed or certified) personnel administer early intervention services even in cases when parents seek out and procure such services would place an unreasonable burden on a parent’s ability to obtain for a child the educational services of providers who are proficient, but not licensed or certified. Such a burden is inconsistent with the remedial purpose of the
statute.”
Relevant Issues: Parents of child with autism wanted their child enrolled in an ABA program early (before 3 years of age) and the Montgomery Count Infants and Toddlers Program disagreed.
Status: Judgment entered in favor of the defendents.
Relevant Issues: Plaintiffs allege that County Defendants unlawfully implemented
policies to prevent, discourage and limit the use of 1:1 Applied Behavior Analysis Therapy (“ABA Therapy”) in the treatment of autistic/PDD children, and that through those policies, 5 children were deprived of appropriate ABA therapy and suffered injury as a result..
Status: Four of the children may proceed with their claims for declaratory relief and two of the children may proceed with their claims for compensatory damages, four of the children may proceed with their other damages and all plaintiffs may proceed with their other damages claims under the Rehabilitation Act against the County.
Relevant Issues: Parent of child with autism and other challenges worked with her child in a Lovaas program and wanted to be reimbursed for her time.
Status: Bucks County v. Dept. of Public Welfare, PA 2004 BUCKS COUNTY DEPT./MENTAL HEALTH v. Pennsylvania, 379 F. 3d 61 – Court of Appeals, 3rd Circuit 2004.pdf United States Court of Appeals, 3rd Circuit Parent of child with autism and other challenges worked with her child in a Lovaas program and wanted to be reimbursed for her time. The court affirms the District Court. “Under the particular circumstances of this case, where a trained service provider was not available and the parent stepped in to learn and perform the duties of a trained service provider, reimbursing the parent
for her time spent in providing therapy is ‘appropriate’ relief.”
Relevant Issues: Child with autism was receiving ABA therapy until 3 years of age. The local health-care provider rejected the claim of medical necessary. Appellant appeals.
Status: The courts affirm the judgment of the Lucas County Court.
Relevant Issues: A child with autism needed continue transportation food and lodging for an ABA program where he thrived in a different town. DSHS denied request for continued transportation.
Status: The court concluded that “DSHS is required to provide medically necessary transportation to services outside a client’s local community only if there is no local provider of those services. Because the Board properly ruled that DSHS was not required to transport S.H. to Richland once the necessary therapy was available in Colville, we affirm. We also affirm the Board’s refusal to consider Ms. H.’s request for increased meal costs because she failed to exhaust administrative remedies.”
Relevant Issues: Child with autism denied “therapy that was “imperative and medically necessary to his treatment plan.”
Status: The court holds that “the exclusions relied upon by the State Health Benefits Program to deny coverage for the treatment sought for autism are void” ….”The court directs that speech and occupational therapy be instituted for” the child “without delay, and that the date of coverage is retroactive to the date of the initial petition.”
Relevant Issues: Child with autism did not receive ABA in a timely fashion.
Status: Defendants motion to dismiss the action of denied in part and granted in part.
Relevant Issues: A class of children with autism require ABA and the DHHS disagreed.
Status: The courts granted the Plaintiffs’ motion.
Relevant Issues: Children with autism were receiving ABA services from a nationally accredited and state certified community mental health agency. This service was to be curtailed.
Status: The court granted the Plaintiffs’ request for injunctive relief because the plaintiffs have a reasonable chance to establish that ABA services are covered by Medicaid.
Relevant Issues: Six children with autism received 100 hours per week of therapy. The Dept. of Public Welfare was planning cuts in service. The parents are fighting these cuts on behalf of their children.
Status: The court granted Plaintiffs’ Motion for Summary Judgment as to liability, but denied declaratory and injunctive relief.
Relevant Issues: Group of children with autism want to be certified as a class to attain medically necessary autism treatment (ABA therapy) as recommended by their health care provider.
Status: Class certification granted.
Relevant Issues: This class action suit is brought on behalf of children with autism whose parents are active or retired military and have TRICARE Basic health benefits which does not cover ABA
Status: The court grants the plaintiff’s motion for summary judgment. The court gives instructions that ABA therapy coverage by provided to basic program beneficiaries (with reimbursement in compliance with the applicable TRICARE guidelines).
Relevant Issues: Child with autism requires ABA therapy; however, the State of Ohio refuses to follow Dr. recommendations and reimbursement.
Status: The court orders at least 40 hours of ABA services per week and reimbursement to the Plaintiffs.
Relevant Issues: The court decides whether the Dep’t of Managed Health Care (DMHC) is required, by law, to direct health plans within its jurisdiction to provide coverage for ABA when provided, or supervised, by BACB-certified therapists who are not otherwise licensed.
Status: The court finds that DMHC is required to order plans to provide coverage for ABA provided or supervised by BACB-certified practitioners from the date of the filing of the petition is properly before this court, for autistic children in Healthy Families and PERS plans with respect to any grievance filed for ABA which was to be provided or supervised by BACB-certified practitioners from the July 1, 2012 operative date of the ABA statute onward.
Relevant Issues: Children with autism who qualify for Medicaid by are not receiving ABA Treatment request to be certified as a class.
Status: The court holds that the Plaintiffs do have a private cause of action under the Medicaid Act.