Already facing sharp criticism over policies that have resulted in the rationing of care to severely disabled children, Florida healthcare regulators are challenging a federal judges order that the state provide a costly but potentially life-changing treatment to children with autism. Last spring, U.S. District Judge Joan Lenard struck down the states refusal to pay for applied behavior analysis (ABA) for autistic children, calling the states policy arbitrary, capricious and unreasonable. The court case involved three autistic youngsters then-5-year-old K.G., 2-year-old I.G. and 4-year-old C.C. whose efforts to obtain behavioral therapy had been denied by the states Medicaid insurance program for needy and disabled people. Lenard ordered that the three children be given the care they sought and that the state provide such care to other autistic children, as well. The state Agency for Health Care Administration has appealed the order, and, in a pleading submitted in November, argued that the ruling strips the state of its ability to weigh requests for the therapy on a case-by-case basis to ensure the treatments are medically necessary. There is no evidentiary support for the district courts conclusion that [behavior analysis] services are medically necessary for all autistic Medicaid recipients under 21, the … Continue reading
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