Military families are asking a federal judge to force the U.S. Defense Department's health insurance plan, TRICARE, to cover medically necessary care for children with autism.
The families filed a motion for an injunction in the U.S. District Court in Washington, D.C., asking that the department and the insurer be mandated to cover the cost of applied behavior analysis therapy, known as ABA therapy, an intensive process that uses rewards and encourages practice to teach and reinforce skills.
The motion alleges that despite evidence from numerous studies and medical professionals supporting the effectiveness of the the therapy, the Defense Department's health plan continues to reject military families' claims. Without the therapy at an early age, the military families say children with autism suffer irreparable harm.
The military families claim that the department avoided paying for ABA therapy for 10 years, first stating that the therapy was "special education," and then shifting its reasoning to say it was not proven to be "medically or psychologically necessary."
The motion is the latest move in a class action suit filed by the military families against the Department of Defense in March 2010. The case is assigned to Judge Reggie B. Walton. A statement from the U.S. Defense Department or U.S. Justice Department was not available.
Treatment for autism is a hot-button issue in the health insurance industry. A growing number of states have passed laws mandating insurance companies to cover evaluation and treatment services for autism.