The
case was filed by Legal Services of Greater Miami (LSGMI) on behalf of three
autistic children residing in Miami. LSGMI has stated that “this case will have
national impact because, while most states mandate that private insurance
companies must cover ABA, most Medicaid programs do not provide coverage.” The
children’s treating physicians explained the extreme disparity between the
prognosis of privately insured children with autism, who receive ABA, and those
on Medicaid, who do not. Medicaid argued that the treatment was “experimental,” and therefore not medically necessary
for a child’s treatment.
Betsy Havens, an Equal Justice Works Fellow, presented the Plaintiffs’ rebuttal expert. Following a lengthy trial that included a review of high quality scientific literature by LSGMI’s expert, Judge Lenard ruled the therapy had long been regarded as safe and effective by mainstream doctors, and that the state was discriminating against poor children by denying it. In Florida, like many states, private insurers are required to cover behavior analysis.