Blue Cross Blue Shield of Michigan Forced to Pay for Autism Care In Landmark
Case

Release issued by Mantese and Rossman, P.C., on June 19, 2009

Detroit, Michigan. The family of an autistic child filed a motion in
federal court today to confirm settlement of a class action against
Blue Cross Blue Shield of Michigan. The family alleged in the suit
that the insurer wrongfully refused to cover behavioral therapy for
children with autism spectrum disorder (ASD), on the baseless ground
that the care was "experimental."

Under the terms of the settlement reached at a court-ordered conference
on Wednesday, June 17, 2009, Blue Cross has agreed to reimburse all
families who paid for behavioral therapy for their children after May 1,
2003, and who were covered under a Blue Cross Blue Shield of Michigan
insurance policy. Blue Cross had earlier filed a motion seeking
dismissal of virtually the entire case on legal grounds, but the
Honorable Stephen J. Murphy III permitted the case to go forward and
scheduled the matter for further proceedings, including a settlement
conference before Magistrate Michael Hluchaniuk.

The settlement was reached in the case of Christopher Johns v. Blue
Cross Blue Shield of Michigan, 08-cv-12272, filed in Detroit. In the
suit, the plaintiff alleged that Blue Cross' pattern and practice of
characterizing the scientifically established Applied Behavioral Therapy
as "experimental," and thus as excluded under its insurance policies,
was arbitrary, capricious, illegal and contradicted by many years of
scientific validation.

Under the settlement, Blue Cross will pay for behavioral therapy
rendered to over 100 children in the last six years. Plaintiff's
counsel, Gerard Mantese and John J. Conway, were pleased with the
settlement. Mr. Mantese and Mr. Conway issued a joint statement
emphasizing: "No insurer should ever take this approach to needed care
for children. Applied Behavioral Analysis therapy is supported by
science and is not 'experimental.' Delays by insurers in authorizing
this treatment, when it is covered by insurance policies, should not be
tolerated. Research shows that children with autism spectrum disorder
need this therapy early on in life and delaying treatment can
irreversibly prevent them from achieving their full potential."

Mr. Mantese emphasized that the settlement includes even families who
never submitted a claim to Blue Cross, but who obtained this care for
their children and were covered by a Blue Cross policy. Mr. Conway
believes that this is the first such settlement addressing Applied
Behavioral Analysis (ABA) in the country.

ABA therapy is administered under the supervision of licensed
psychologists and other professionals. ABA applies one hundred year old
concepts of changing behavior through positive and negative
reinforcements. The federal suit in which this settlement was achieved
centered upon the ABA treatment provided by prestigious Beaumont
Hospital and its HOPE Center, including Dr. Ruth Anan and Dr. Lori
Warner.

The case settled shortly after Plaintiff's counsel obtained a court
order requiring Blue Cross to produce file documents which validated the
effectiveness of ABA therapy for treating children with autism spectrum
disorder. Among the documents in the Blue Cross files obtained by
Plaintiff's counsel was a draft of a Blue Cross Blue Shield Medical
Policy for 2005, which acknowledged the following:

Applied behavioral analysis (ABA) is
currently the most thoroughly researched treatment modality for early
intervention approaches to autism spectrum disorders and is the standard
of care recommended by the American Academy of Pediatrics, National
Academy of Sciences Committee and the Association for Science in Autism
Treatment, among others.

Blue Cross' own documents further acknowledged that:

The earlier the disorder is diagnosed,
the sooner the child can be helped through treatment interventions.

Mr. Mantese stated, "After we compelled Blue Cross through motion
practice to produce all materials supporting its position that this care
was allegedly experimental, we received numerous file documents which
actually established that ABA therapy works and is highly effective in
increasing the functioning of these children."

Mr. Conway emphasized, "We are pleased that we were able to obtain a
result which will require Blue Cross to pay for this important care and
will alleviate some of the financial strain imposed on over a hundred
families by having to pay for this care when it was covered under their
insurance policies."

Contact information for the families' attorneys follows:

Gerard Mantese, Esq.

Mantese and Rossman, P.C.

1361 E. Big Beaver Road

Troy, Michigan 48083

248-457-9200 Office

248-515-6419 Cell

John J. Conway, Esq.

John J. Conway, P.C.

645 Griswold St, Ste 3600

Detroit, MI 48226

313-961-6525 Office

313-574-2148 Cell