Due to the high volume of calls, we're experiencing a higher-than-usual backlog.

We appreciate your patience. In the meantime, please refer to our Resource Directory, Special Education Legal Library, or Insurance Portal as needed on our website while you're waiting

Gala 2023MORE INFO

Boeing's Hidden ABA Therapy Exclusions To Treat Autism

Aerospace giant Boeing has been hit with a Complaint in federal court by its employees who claim the company's denial of insurance coverage of applied behavior analysis (ABA) for their children with autism violates the federal Mental Health Parity Act. Filed by two families whose sons have autism, "C.S." and "D.Z.", the suit seeks certification as a class action on behalf of Boeing's 81,000 Washington-based employees.

"The company has refused to negotiate autism spectrum Benefits into our contract with Boeing for a number of years" said Professional Aerospace Union spokesperson Matthew Kempf.  "It's unfortunate the company has put families in a situation where legal action is the only avenue remaining."

"We are very interested in the outcome of this case, as Boeing self-insures its employee health plan, not regulated by the Office of Insurance Commissioner" said Arzu Forough, Chief Executive Officer of Washington Autism Alliance & Advocacy. “This could be a turning point for the children of hundreds of Boeing employees who've been struggling to cover their children's treatment expenses."

The suit was filed by Ele Hamburger and Richard Spoonemore of Sirianni Youtz Spoonemore & Hamburger, who have been winning a series of similar federal class action suits over ABA denials. The complaint alleges Boeing's denial of ABA benefits violates the 2008 Wellstone Domenici Mental Health Parity and Addiction Equity Act as well as its fiduciary responsibilities under ERISA.

Boeing does not expressly exclude ABA coverage in its health plan, but rather has its claims administrators exclude all coverage of ABA therapy through internal policies and restricted provider networks, the complaint alleges.

The class consists of all individuals who have  been,  are,  or  will  be  Washington  state  participants  or   beneficiaries under The Boeing Master Welfare Plan that have been, are or will be in effect or renewed.  If you may be a class member  please contact Ele Hamburger via E-mail:  ehamburger@sylaw.com

Boeing’s non-mental health claims administrator, Blue Cross Blue Shield of Illinois (BCBSIL), excluded ABA therapy coverage. When a Boeing employee overturned the denial, according to the complaint, Boeing directed BCBSIL to classify ABA therapy as a mental health service to be administered by Value Options, which administers Boeing’s mental health claims.

Boeing directed Value Options to limit its provider network in Washington state to exclude licensed ABA agencies, the plaintiffs assert.

"The effect of Boeing/Value Option’s failure to include in its network any licensed ABA agencies in Washington state is the same as a blanket exclusion," according to the complaint. "It is impossible for plaintiffs and the proposed class to obtain coverage for the ABA therapy services they need because Boeing will not contract with any providers who can deliver it."

The Mental Health Parity Act does not require Boeing to cover mental health services; rather it requires employers if they do choose to provide mental health coverage -- as the Boeing plan does-- to cover the benefits “at parity” with medical benefits. ERISA requires Boeing to abide by the Mental Health Parity Act and other regulation in administering its plan.

"By applying a blanket, hidden exclusion of ABA therapy to treat (autism), in violation of the Parity Act and its regulations, Boeing is  systemically  and  uniformly  failing  to  properly  administer  its  Plan," according to the complaint. "It is also breaching its fiduciary duties to plaintiffs and class members, who have not received the benefits to which they are entitled."

The suit seeks a court order stopping Boeing from denying ABA coverage in its health plan. It also seeks a court order declaring Boeing’s exclusion of coverage for ABA therapy to treat ASD through a restricted network of providers void and unenforceable.   The lawsuit further seeks an injunction to prevent any future or ongoing efforts by Boeing to use and enforce any blanket exclusions of ABA therapy to treat ASD.

###

Without your time, commitment, and contributions WAAA would not succeed as an organization. It is only together that we can work towards our goal of improving outcomes for all who struggle with autism spectrum disorders.

Join us as we honor Attorney Ele Hamburger of Sirianni Youtz Spoonemore & Hamburger on May 10 at our Night Out For A Cause at Novelty Hill - Januik Winery.

Thank you for standing together with us for change.

 

Share this article 

Leave a Reply

Related Posts:

phonemap-markercross linkedin facebook pinterest youtube rss twitter instagram facebook-blank rss-blank linkedin-blank pinterest youtube twitter instagram