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Federal Class Action Filed Against Oregon Insurer for Denying ABA

May 10, 2013

PORTLAND (May 10, 2013) -- A federal class action lawsuit has been filed against Providence Health Plan claiming its denial of ABA coverage for autism treatment violates federal and state mental health parity laws.

Brought by the parents of two children, "A.F." and "A.P." alleges Providence “has established and carried out a deliberate company-wide policy to deny all claims for ABA treatment in violation of U.S. and Oregon law.” The mother of  A.P., Lucia Alonso, lost her home to foreclsoure when she could no longer afford both her mortgage and paying her child's ABA bills out-of-pocket due to the lack of insurance coverage.

The suit claims Providence's claims denials violate the 2008 Wellstone Domenici Mental Health Parity and Addiction Equity Act, Oregon's Mental Health Parity Act, and a state statute requiring that children with pervasive developmental disorders, such asd autism, receive “all medical services, including rehabilitation services, that are medically necessary and are otherwise covered under the plan.”

The suit was filed as a bill is moving through the Oregon Legislature requiring all state-regulated health plans to cover the screening, diagnosis and treatment of autism.