A.F., et al, v. Providence Health Plan, Opinion & Order

On January 7, 2016, a District Court judge in Oregon ruled that families suing Providence Health Plan for denying coverage of applied behavior analysis (ABA) can seek repayment of what Providence would have spent on the claims. In an earlier ruling the court ordered Providence to repay the plaintiffs for their out-of-pocket expenses for the denied ABA claims. The plaintiffs are seeking repayment of what Providence would have spent on ABA if services had been covered because the families were not able to pay for ABA at the needed service intensity. The plaintiffs contend that Providence should not . . .