Raytheon Class Action Says Speech Therapy Benefits Denied

By Emily Sortor | February 3, 2020

Category: Insurance

Speech therapy session Parents of a five-year-old autistic boy have filed a class action lawsuit over claims that Raytheon Company wrongly denies speech therapy benefits.

The Raytheon speech therapy class action lawsuit was filed by parents, referred to as S.R. and T.R., on behalf of their son, known as N.R.

Allegedly, N.R. was diagnosed with autism-spectrum disorder in 2017, and a doctor recommended that he receive speech therapy services to treat conditions such as mixed receptive-expressive language disorder and phonological disorder, among other conditions.

The Raytheon class action lawsuit says that N.R.’s parents submitted claims for benefits through Raytheon, which were denied by United Healthcare, the third-party administrator for the plan.

These benefits were denied even though the claims were made for services medically necessary for the child’s mental and physical well-being, according to the plaintiffs.

The parents aim to end what they say is a standard practice of discrimination against people with autism spectrum disorder, as well as other developmental mental health conditions. According to the parents, speech therapy can “dramatically improve the health and life-long well-being” of individuals with such conditions.

The Raytheon class action states that Raytheon does not cover medically necessarily speech therapy to treat developmental mental health conditions because they qualify as “non-restorative” therapy. Raytheon’s plans reportedly do not cover non-restorative speech therapy and “habilitation services.” The parents elaborate, saying these therapies are listed as exclusions under the plan’s coverage.

The speech therapy class action lawsuit argues that these therapies can be medically necessary, even when there is no prior loss of speech, and should be covered. Additionally, the Raytheon class action lawsuit argues that the “exclusions” as listed by Raytheon are actually disability discrimination, because they exclude coverage for medically necessary services for people with developmental health conditions.

S.R. and T.R. seek to enforce the Federal Mental Health Parity Act, which they say applies to the Raytheon plan through ERISA, the Employee Retirement Income Security Act. The parents explain that the Parity Act was enacted in 2008 to expand the scope of legislation regarding mental health coverage. Allegedly, this act was “designed to end discrimination in the provision of coverage for mental health and substance use disorders, as compared to medical and surgical conditions.”

The parents summarize by saying that the law requires that coverage for mental health services not be more restrictive than coverage for physical health care. In their view, Raytheon’s failure to cover non-restorative speech therapy and habilitation violates the Federal Mental Health Parity Act.

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The parents are represented by Stephen Churchill of Fair Work PC, and by Eleanor Hamburger and Richard E. Spoonemore of Sirianni Youtz Spoonemore Hamburger PLLC.

The Raytheon Health Insurance Claim Denial Class Action Lawsuit is N.R., et al. v. Raytheon Company, et al., Case No. 1:20-cv-10153, in the U.S. District Court for the District of Massachusetts.