Latest Cases

Tappert v. Anthem Blue Cross and Blue Shield (Arbitration Award)  -- Colorado Trial Lawyers Association Case of the Year Finalist

At issue in the Tappert case was whether Anthem Blue Cross and Blue Shield must cover “ABA autism therapy” for the Tappert’s four-year-old daughter. ABA autism therapy is a type of therapy for the treatment of autism that uses the principles of applied behavioral analysis. In order to be effected, children must receive at least 25 hours of ABA autism therapy per week. As such, it is quite expensive. Most insurers deem ABA autism therapy “experimental and investigational,” and, therefore, not medically necessary.

In a landmark decision, Judge William G. Meyer, held that ABA autism therapy is medically necessary and a covered benefit of the policy, requiring Anthem to pay $110,000 in prior expenses.

The impact of Judge Meyer’s ruling is far-reaching, providing hope for parents of children with autism across the country. The award paves the way for additional rulings in favor of this much-needed therapy. Importantly, the underlying litigation brought to light the fundamentally flawed scientific reasoning behind Anthem’s medical policy regarding ABA therapy. The Tappert case gives countless families across the country hope for some financial relief through insurance or other health benefit plans.