MIAMI (January 7, 2013) -- The state of Florida is appealing a 2012 federal court order that it cover ABA for children with autism under Medicaid, arguing it should have the right to make the determination on a case-by-case basis, the Miami Herald reports. Autism Speaks is intervening in the case on behalf of the plaintiffs, three young children who were denied ABA coverage.
The state Agency for Health Care Administration (AHCA), which manages Florida's Medicaid program is contesting U.S. District Court Judge Joan Lenard's ruling that its denial of ABA coverage under Medicaid was "arbitrary, carpicious and unreasonable." The judge found AHCA's claim that ABA was experimental "outrageous."
Autism Speaks, in a friend-of-the-court brief filed as part of the appeal, charged AHCA was trying to mount “serial rematches” against disabled children. The state already has the power to determine medical necessity, it was argued.
The plaintiffs contend Florida is discriminating against lower-income children by denying Medicaid coverage for ABA because it requires state-regulated private health plans to provide the coverage by law.