Reid v. BCBSM, Inc.

Tracy Reid (plaintiff) had an autistic son, M.A.R. (plaintiff), who required intensive behavioral therapy. M.A.R. was diagnosed with autism spectrum disorder in 2008 and underwent intensive behavioral therapy through 2012. The therapy allegedly reduced M.A.R.’s violent tantrums and aggressive behavior and allowed him to attend school with nondisabled peers. At the time, Reid had HealthPartners (defendant) insurance through her employer. The plan explicitly excluded intensive behavioral therapies for the treatment of autism, and HealthPartners denied Reid’s claims based on the exclusion. Reid exhausted her internal appeals and filed an external appeal with an organization contracted with the Minnesota Department of Commerce (MNDC) (defendant). The denial was affirmed. Reid became self-employed and purchased a Blue Cross Blue Shield of Minnesota insurance (Blue Cross) (defendant) plan that did not exclude autism treatments. Nevertheless, Blue Cross denied the claim saying the therapy was not medically necessary. Reid successfully appealed the denial, but Blue Cross subsequently notified Reid that it was adding an explicit exclusion for intensive behavioral therapies to treat autism. Reid filed suit against the insurers, MNDC, and MNDC’s commissioner, Michael Rothman (defendant), alleging claims under the Americans with Disabilities Act (ADA) and several other statutes. The insurers, MNDC, and Rothman moved to dismiss Reid’s claims.