Burke, A. v. Independence Blue Cross

J. A11007-15
2015 PA Super 235ANTHONY BURKE, : IN THE SUPERIOR COURT OF
BY HIS PNG JOHN BURKE : PENNSYLVANIA
:
v. :
:
INDEPENDENCE BLUE CROSS, :
:
Appellant : No. 2299 EDA 2011
Appeal from the Order Entered July 19, 2011
In the Court of Common Pleas of Philadelphia County
Civil Division at No. February Term, 2010, No. 002226
BEFORE: FORD ELLIOTT, P.J.E., WECHT, and FITZGERALD,* JJ.
DISSENTING STATEMENT BY FITZGERALD, J.: FILED NOVEMBER 13, 2015
I respectfully dissent. Insurance coverage of autism-related services
conducted at schools via the Autism Coverage Law (“ACL”) is a laudable and
noteworthy goal. As the majority observes, thirty members of the
Legislature, the former Governor, and the Pennsylvania Insurance
Department support a construction of the law requiring private health
insurers to cover applied behavior analysis (“ABA”) autism treatment
services conducted at schools, thereby relieving the Commonwealth from
shouldering some of the costs. But in my view, I perceive no statutory basis
warranting that construction. If our Legislature intended for private health
insurers to cover ABA services provided in schools, then it could have
explicitly excluded such services from the limiting provision at 40 P.S. §
764h(c). Accordingly, I respectfully dissent.
*
Former Justice specially assigned to the Superior Court.