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State Reaches Settlement In Autism Lawsuit

Ruby de Luna

Autism therapy will soon be covered by state public employees' health plan. The Washington Health Care Authority has reached a settlement with families who sued the state for coverage. We get more from KUOW's Ruby de Luna.


The case was filed three years ago by a family with two sons who were both diagnosed with autism. Uniform Medical Plan denied their claims for autism therapy because it wasn't part of their health plan.

Eleanor Hamburger is a lawyer representing families in the class–action suit. She says insurers are required to cover medically–necessary treatment for autism, by law — the state's Mental Health Parity Act. She says the law is not limited to psychiatric conditions. It applies to services for development disabilities, too.

Hamburger: "It applies to autism, it applies to mental retardation, it applies to other kinds of developmental disabilities, as long as they're listed in the 'DSM–IV,' which is the 'Diagnostic and Statistical Manual.'"

The "Diagnostic and Statistical Manual of Mental Disorders" lists all mental health conditions for both adults and children. It's a manual used by mental health providers and health insurers.

If approved the settlement could affect more than 800 people covered by Uniform Medical Plan who are diagnosed with some form of autism.

Yesterday's announcement is the second settlement involving autism therapy. Last week Group Health agreed to a similar settlement. There are six lawsuits challenging insurance companies' policy to deny coverage for autism.

I'm Ruby de Luna, KUOW News.

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