United Healthcare Loses Challenge to Plan Autism Care Exclusion

A health plan term explicitly excluding certain autism treatments from coverage violates the federal Mental Health Parity and Addiction Equity Act, a federal judge in California said, ruling in favor of a woman who sued United Behavioral Health and United Healthcare Services Inc. for refusing to cover her autistic son’s treatments.

The health plan in question expressly covered autism while explicitly excluding “Intensive Behavioral Therapies such as Applied Behavior Analysis” for treatment of autism spectrum disorders, Judge Yvonne Gonzalez Rogers of the U.S. District Court for the Northern District of California said. This violates the “plain terms” of the parity ...