Family’s Challenge to Blanket Autism Coverage Exclusion Trimmed

The parents of a four-year-old autistic child who sued their health plan for categorically excluding an autism treatment called applied behavioral analysis can challenge this practice under the Affordable Care Act’s anti-discrimination rule but not federal benefits or mental health parity law, according to a federal judge in Indiana.

The Heart of CarDon LLC health plan’s “blanket exclusion” for coverage of autism spectrum disorder treatments is valid under the federal Mental Health Parity and Addiction Equity Act, because it doesn’t draw impermissible distinctions between mental health treatments and medical and surgical treatments, Judge Tanya Walton Pratt of the U.S. District ...