By David Honigman
WASHINGTON, Jan. 25, 2011 /PRNewswire/ — Military families have filed a motion for an injunction to mandate that the Defense Department’s insurer, TRICARE, cover medically necessary care needed by military families’ children with autism. The motion seeks a mandate that TRICARE cover the cost of Applied Behavior Analysis therapy, or ABA, which is effective in treating children with autism spectrum disorder.
According to the military families, without ABA therapy at an early age, children with autism will suffer irreparable harm. The motion alleges that numerous studies and medical professionals confirm the effectiveness of ABA therapy, yet the Defense Department continues to reject military families’ claims for the therapy, relying on shifting rationales.
The case is entitled Berge v. United States of America, et al., No.10-cv-00373-RBW (D.DC), assigned to Judge Reggie B. Walton.
The military families allege that for approximately 10 years the Defense Department and TRICARE have avoided paying for ABA therapy by incorrectly claiming it was “special education” and therefore not payable under the military insurance program. After the military families demonstrated in their written arguments that the Defense Department’s position was incorrect, the Defense Department shifted and began claiming that ABA therapy is not proven to be “medically or psychologically necessary.”