Providence sued over autism treatment coverage

Providence sued over autism treatment coverage

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by Rich Kurz

kgw.com

Posted on May 9, 2013 at 6:15 AM

Updated Friday, May 10 at 5:49 AM

PORTLAND -- A Portland family that has a child with autism is suing health insurance provider Providence Health Plan after the family says the plan denied them a doctor-recommended therapy.

Today, Lucia Alonso’s 6-year-old son is talking and going to school. It didn’t always seem so hopeful.

At 14 months, she says he stopped using the few words he knew and avoided eye contact. Her son’s doctor recommended a treatment called ABA, or Applied Behavior Analysis. Alonso credits that treatment for helping to slowly bring back her son’s social interaction.

There’s one big problem—she can’t pay for it.

"Everyday people like us can’t afford to spend three to four hundred a week on therapy,” Alonso said.

She says her insurer, Providence Health Plan, repeatedly denied her coverage for the ABA sessions. After consulting with other parents who faced the same struggle she decided to hire a lawyer and file a class action lawsuit in U.S. District Court.

“Oregon law mandates health insurance policies include mental health coverage and autism falls under mental health,” said Alonso’s lawyer, Keith Dubanevich.

KGW contacted Providence Health Plan and a representative said the company had not seen the lawsuit and would not comment until it had.

The Alonso’s attorney says it could be seven months or more before a judge hears the case. In the meantime, Lucia Alonso’s son and others like him wait to go back to ABA therapy.

“If I have to go through all the trouble to open the door to them to get treatment, that’s what I’m willing to do,” she said.

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