Nebraska should pay for treatments needed by children with ASD, says judge

Lancaster County, Neb. — A Lancaster County judge ruled Tuesday that the state of Nebraska must pay for the treatments needed by children with autism spectrum disorder (ASD) who are Medicaid-eligible.

District Judge John Colborn decided in his 19-page order that the Nebraskan Department of Health and Human Services violated federal law through a policy it adopted that excludes treatments that are often deemed necessary by doctors for children with ASD.

Judge Colborn ordered the state to immediately refrain from enforcing its unlawful policy, and to start covering treatments such as Applied Behavior Analysis for Medicaid-eligible children with ASD.

The organization responsible for filing the lawsuit, the Nebraska Appleseed Center, released a statement Wednesday calling Judge Colborn’s decision a “big win” for the Nebraskan children. According to Legal Director Sarah Helvey:

“This ruling is an important victory for Nebraska families with children who have been wrongfully denied access to essential mental and behavioral health treatments that were recommended by their doctors.”

“The court’s ruling will allow more children to get the care they need to have the best possible future.”

The state’s Department of Health and Human Services, on the other hand, said it is coordinating with the Attorney General to determine what steps need to be taken next. According to HHS Spokeswoman Kathy Osterman:

“I can tell you that we’re reviewing the decision and working with the Attorney General’s Office to determine our next steps.”

The lawsuit filed by Appleseed stemmed from a case of two young children with autism who were denied the treatments recommended by their doctors because of the policy the HHS was implementing.

The state of Nebraska has been given 30 days to decide whether it wants to appeal the judge’s decision.

Source: Lori Pilger: Judge: State must cover medically necessary autism services