Autism Speaks Hails Ruling by Federal Judge Ordering Medicaid Coverage

NEW YORK (March 26, 2012) --  Autism Speaks, the nation's largest autism science and advocacy organization and the leading voice on autism insurance reform, today hailed Friday’s decision by U.S. District Court Judge Joan Lenard ordering Florida’s Medicaid program to cover Applied Behavior Analysis (ABA) immediately, finding the treatment was medically necessary and not “experimental” as claimed by the state. The written order was issued today and applies to all Medicaid-eligible individuals under 21.

“This ruling has potentially tremendous import for Medicaid autism coverage around the nation,” said Lorri Unumb, Esq, Autism Speaks’ vice president for state government affairs. “Judge Lenard’s ruling confirms what Autism Speaks and other autism advocates have argued for years – the evidence is in and it is unequivocal. ABA improves the lives of people with autism, particularly during the critical early years of their lives, and must be covered by all insurance plans.”

Unumb, who provided consultation to the plaintiffs in the case, K.G. v Dudek, directs Autism Speaks’ autism insurance reform campaign that has led 29 states to enact laws directing insurance companies to stop fighting ABA and start covering it. Through decades of research, ABA has developed many techniques for increasing useful behaviors and reducing those that may be harmful or that interfere with learning.

In her ruling, Judge Lenard said in her 16 years on the bench, the case “if not the most important, is one of the most important cases that I have ever heard."

Lenard ruled the plaintiffs had established that “there exists in the scientific and medical peer-reviewed literature a plethora of meta-analyses, studies and articles that clearly establish ABA as an effective and significant treatment to prevent disability and to restore children to their best possible functional level and restore their developmental skills.”

She chastised the Florida Medicaid agency – the Agency for Health Care Administration – for failing to properly examine the evidence underlying ABA and for dragging its feet for years in studying the issue. “How many children were lost?” the judge asked.

Marking the time she issued her ruling, Judge Lenard said, “the State of Florida is hereby ordered to provide ABA treatment when it is appropriately prescribed by a medical professional immediately.”

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