SAN ANTONIO – Texas RioGrande Legal Aid and Disability Rights Texas have filed a lawsuit against Texas Health and Human Services Executive Commissioner Charles Smith and Texas Medicaid director Gary Jessee on behalf of 5-year-old Bexar County twins and a teenager who have autism in a bid to get them Medicaid coverage for medically necessary treatment.
Although federal law gives children the right to receive necessary treatment, applied behavioral analysis, which the Texas Human Services Commission describes as “the most recommended, evidence-based treatment” for the autism spectrum disorder, is excluded from the Texas Medicaid program.
The TRLA said the twin boys have received some applied behavioral analysis, but the teenager has received none. The therapy provided to the twins is not enough to improve their condition, the TLRA said.
The plaintiffs are among nearly 160,000 Texas children who are estimated to have the disorder, the TLRA said.
“Texas is one of only a handful of states still refusing to comply with the law and provide children with autism spectrum disorder, the ABA treatment they medically need, and which their treating professionals have prescribed,” said Peter Hofer, co-counsel and an attorney with the DRTX. “Until Texas Medicaid decides to comply with the law or is ordered to do so, these young children will continue to suffer irreversible harm to their health and development.”
Applied behavioral analysis uses proven treatments to help children with autism improve their ability to communicate, develop personal relationships, control behavior and adapt to their surrounding, the TLRA said.