Parents’ League for Effective Autism Services v. Jones-Kelley
United States District Court for the Southern District of Ohio
565 F. Supp. 2d 905 (2008)
Parents’ League for Effective Autism Services (PLEAS) (plaintiff) was an association of families with children diagnosed with autism. These children were receiving applied-behavioral-analysis (ABA) therapy that was recommended for them by licensed healthcare providers and was funded by Medicaid. The State of Ohio (state) (defendant) proposed new administrative rules that limited Medicaid coverage of mental-health services to rehabilitative services. The state then concluded that ABA therapy for children with autism was habilitative rather than rehabilitative and thus would no longer be covered by Medicaid. PLEAS filed suit against the state and moved for a preliminary injunction to stop the state from implementing the proposed rules. PLEAS asserted that the proposed rules violated the early and periodic screening, diagnosis, and treatment (EPSDT) provisions under the Medicaid Act (act). The state argued that ABA therapy for a child with autism was not rehabilitative because the therapy did not restore any skills that the child previously had. PLEAS’s evidence established that ABA therapy for children with autism, if recommended by a licensed practitioner of the healing arts, was a medically necessary service that provided the maximum reduction of a mental or physical disability.
Rule of Law
Holding and Reasoning (Graham, J.)
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