Nebraska Medicaid won’t appeal court ruling on autism coverage

Lincoln, Neb. — Medicaid will no longer fight a court’s ruling that requires it to start covering autism treatments that are potentially costly, but likely effective.

In a court ruling issued June 30, Lancaster County District Judge John Colborn said that he found insurance coverage prohibitions on mental health treatments for developmental disorders violated federal law.

Although Nebraska Medicaid objected to the inclusion of autism treatments in its insurance coverage in the past, state Medicaid Director Calder Lynch said it would no longer appeal the judge’s ruling, citing that Medicaid has had a change of heart following federal directives and changes on what medical experts deem effective in autism treatments.

He told:

“Given the judge’s ruling and how we’ve seen this issue evolve, it didn’t make sense to continue the appeal process.”

The judge’s ruling will now require Medicaid to cover treatments like Applied Behavior Analysis (ABA), which many experts believe can be the most effective treatment for children with autism, if applied correctly.

The order stemmed from a lawsuit filed by the National Health Law Program and the Nebraska Appleseed Center for Law in the Public Interest in 2012 on behalf of two young boys with autism who were denied insurance coverage for ABA therapies recommended by their psychologists. A lawyer for the boys, Robert McEwen, told:

“We now look forward to swift and complete implementation of the court’s decision so that children with serious behavioral needs can get the important services they need.”

Source: Martha Stoddard Kearney in Hub Nebraska won’t appeal ruling expanding autism coverage under Medicaid