Pennsylvania Court Rules Insurers Must Cover School-Based Applied Behavioral Analysis Under Autism Treatment Mandate

On November 13, 2015, the Pennsylvania Superior Court ruled that Independence Blue Cross (IBC) was required to provide coverage for school-based applied behavioral analysis (ABA). The lawsuit, Burke v. IBC, was filed by the Pennsylvania Health Law Project on behalf of the family of a six-year-old boy after IBC denied the family’s request for coverage of services provided at the boy’s elementary school. IBC not only claimed that the services were excluded because they were being delivered in a school-based setting, but challenged the authority of Pennsylvania's autism insurance mandate as well. The . . .