Intensive autism therapy gets court hearing

Categories: Health Care

MaxReid.jpg
Max Reid's treatment for autism was initially uncovered by his insurance.
We first told you about the fight over Intensive Early Intervention Behavioral therapy for kids with autism in our January feature.

More recently, the issue got prominent treatment in a two-part series on the cover of the Star Tribune.

Then, on Monday, the Ramsey County judge presiding over a lawsuit on the subject, smacking down the Department of Human Services for its seemingly unequal treatment of autistic children.

Autism advocates across the country are involved in a fight to force insurance companies to cover the intensive behavioral therapy, which goes by many names and acronyms, and point to studies showing that nearly half the autistic children who receive the therapy benefit so much that they no longer meet the diagnostic standards for autism.

The problem is that the therapy is incredibly expensive -- often running to more than $100,000 -- and not everyone is convinced it's as effective as it's supporters claim.

But there's an even more fundamental question at stake in Minnesota today -- why the state covers the therapy for kids covered by one kind of Medical Assistance but denies it to kids enrolled in Medical Assistance because of their families' low incomes.

That's the question Judge Robert A. Awsumb was trying to answer in his order Monday.

"This court finds it inconsistent that parents of a child with autism enrolled in MA-FFS would have a choice between ABA/IEIBT and CTSS providers, while parents of a child with autism who is enrolled in MA-PMAP serviced by HealthPartners do not have the same choice," Awsumb writes. "If the services provided truly are the same, then why are some covered and some not?"

Rephrased without the alphabet soup, the question is this: why is the state denying poor kids the same treatments it's covering for other kids?

Awsumb sent the case back down to an administrative law judge with instructions to get to the bottom of that question.

Amy Dawson, the autism advocate who brought the suit on behalf of a young boy known to the court as T.O., told City Pages today she's thrilled with the result.

"This is going to let us get to the heart of the matter," Dawson said. "We're going to subpoena state officials, and we're going to get some answers. It may take a long time, but I know we're going to win."


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