Appeals Court Upholds Speech Therapy Denial

February 10, 2003 (PLANSPONSOR.com) - A federal appeals court has handed another defeat to a group of Michigan plaintiffs who sued Blue Cross and Blue Shield of Michigan under the Americans with Disabilities Act (ADA) for not paying for speech therapy.

The 6 th Circuit Court of Appeals ruled that the benefit plans in which the plaintiffs participated through their employers are not “goods offered by a place of public accommodation” and, therefore, are not subject to the ADA, Washington-based legal publisher BNA reported.

“The appellants did not obtain their health care coverage directly from Blue Cross Michigan nor did they buy their respective policies from an insurance office. Rather, they obtained their benefits through their employer,” wrote Chief Circuit Judge Boyce Martin Jr. “Thus, there is no nexus between the disparity in benefits and the services which Blue Cross Michigan offers to the public from its office.”

A group of participants and beneficiaries in separate employer-sponsored health plans sued Blue Cross of Michigan in a Michigan state court alleging it violated state law and the ADA by denying reimbursement for speech therapy provided to a number of child beneficiaries. The case was transferred to the US District Court for the Eastern District of Michigan where the federal court dismissed the case.

The case is Kolling v Blue Cross & Blue Shield of Michigan, 6th Cir., No. 01-2117, 2/7/03.

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