Military families file lawsuit against DoD for failure to pay for autism treatment

Military families with autistic children filed a class-action lawsuit this week against the Department of Defense and TRICARE, its health benefits division, for its refusal to pay for applied behavior analysis therapy (ABA).

According to David M. Honigman, an attorney with Troy, Mich.-based Mantese Honigman Rossman and Williamson, P.C., which brought the complaint, ABA is a proven treatment for autism and one that has its greatest effect when started early in life.

"What it really comes down to is this is expensive therapy, requiring as much as 30 to 50 hours of treatment each week," Honigman said. "The Department of Defense continues to think of excuses to pretend to pay for it when they don't."

Shortly after news of the lawsuit was made public, Department of Defense attorneys issued a policy letter stating, "The TRICARE Management Activity has vacated any previous instruction it may have issued to its contractors that ABA is not covered under the Basic Program."

In addition, the Department of Defense recently requested that all action on the case, Berg v. United States of America, et al, filed in federal district court in Washington, D.C., be stayed and the matter be remanded to enable the DoD to study the issue further.

Honigman regards both the policy letter and the request for a stay as delaying tactics which deny treatment for the estimated 22,000 families with autistic children served under TRICARE.

At the heart of the dispute is the DoD's contention that ABA therapy is "special education" and not therapy, despite the fact that many organizations, including the United States Army, the Army and Marine Corps Autism Task Force and the Executive Director of the National Autism Center, agree that ABA therapy is not special education.

"There is legal precedent and ample evidence that ABA therapy is effective in treating autism," said Honigman. "The unstated reason for denial of claims is simply that it is expensive."

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