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Parents of Autistic Children Fight Back -- Warn HMO Regulator Against Siding With Insurers Refusing to Pay for Treatment
Date:2/25/2009

bly top officials of the Schwarzenegger Administration -- to derail the patient protection process that requires health care companies to provide coverage for treatment that independent doctors determine is medically necessary.

Consumer Watchdog was joined by attorney Scott Glovsky, and the parents of two autistic children -- Andrew Arce and Frank Nagle -- who were denied treatment by their insurer, Kaiser Permanente. Glovsky represents the Arces and Nagels in their lawsuits against Kaiser, and has other lawsuits pending against Blue Cross.

"Kaiser is still dumping their patients, but instead of dumping them on skid row they are dumping the cost of treating autistic children on taxpayers," said Scott Glovsky. "Kaiser is blatantly violating California law and abandoning autistic children at a time when their window within which to recover is closing fast."

Families of autistic children say insurers have turned them away, suggesting that the families turn to the limited resources of the public school special education system for help. Consumer Watchdog said that dumping insured patients on taxpayers by redefining treatment as a school responsibility is reprehensible -- unfair to taxpayers, to public schools, to patients and their families.

The Arces and the Nagles have both successfully challenged their insurers' refusal to provide treatment for their autistic children. In both cases, the state Independent Medical Review (IMR) organization overruled Kaiser's refusal to provide coverage.

Now, apparently in response to pressure from health plans that want to avoid the expense of autism treatment, the state regulators are reportedly contemplating action that would evade the insurance requirement. The net effect will be to force victims of the disease and their families to seek help from taxpayer-funded programs.

Governor Schwarzenegger, who appointed the cu
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SOURCE Consumer Watchdog
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