LSGMI Wins Major Victory for Children on Florida Medicaid Suffering from Autism Disorders

At 10:50 a.m., March 26, 2012, U.S. District Judge Joan Lenard ordered the State of Florida to immediately begin providing coverage of Applied Behavior Analysis (ABA) for all children on Florida Medicaid who are diagnosed with an autism spectrum disorder. In issuing an initial oral order from the bench, Judge Lenard said that “The Medicaid population of children diagnosed with autism and/or autism spectrum disorder are deserving and will be given ABA treatment in the State of Florida,” referring to this as “one of the most important cases I have ever heard.

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The case, brought on behalf of three autistic Miami children, was handled by Monica Vigues-Pitan (Legal Services of Greater Miami, Inc.. Advocacy Director); Miriam Harmatz, who served as lead counsel, and Betsy Evans ((Florida Legal Services); and Neil Kodsi (Alderman Kodsi), who provided trial expertise on the case. “This order will save thousands of other Florida children from being unnecessarily and permanently disabled,” said Vigues-Pitan, who has worked closely with the three children and their families for over one year.

“Judge Lenard’s order will eliminate the tragic disparity between the prognosis of privately insured children with autism, who receive ABA, and those on Medicaid, who do not, ” said Harmatz, who is one of the state’s leading Medicaid advocates. “This case will have national impact because, while most states mandate that private insurance companies cover ABA, most Medicaid programs do not provide coverage.”

The Florida Medicaid Agency’s main defense was that ABA was “experimental” and unproven. Citing to an abundance of high quality scientific literature, the Plaintiffs’ rebuttal expert “laid to rest the outrageous claim that ABA is experimental.”