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BURKE EX REL. BURKE v. INDEPEND. BLUE CROSS

No. 31 EAP 2013.

103 A.3d 1267 (2014)

Anthony BURKE, by his Parent and Natural Guardian, John BURKE, Appellant v. INDEPENDENCE BLUE CROSS, Appellee.

Supreme Court of Pennsylvania.

Decided October 31, 2014.

Attorney(s) appearing for the Case

Rodney A. Corey, Esq. , Tara Lynn Smith, Esq. , PA House of Representatives, Nora Winkelman, Esq. , PA House Democratic Caucus, for Members of the Pennsylvania House of Representatives, amicus curiae.

A. Roy DeCaro, Esq. , Gerald Austin McHugh Jr., Esq. , Stephen Edward Raynes, Esq. , Raynes McCarty, Philadelphia, for Dennis O'Brien, Amicus Curiae.

Kate Williams Ericsson, Esq. , Cheryl Ann Krause, Esq. , Dechert LLP, Philadelphia, for Autism Speaks, amicus curiae.

David George Gates, Esq. , PA Health Law Project, for Anthony Burke.

Gerald J. Dugan, Esq. , Dugan, Brinkmann, Maginnis & Pace, Philadelphia, William H. Lamb, Esq. , Maureen Murphy McBride, Esq., Lamb McErlane, PC, West Chester, for Independence Blue Cross.

CASTILLE, C.J., SAYLOR, EAKIN, BAER, TODD, MCCAFFERY, STEVENS, JJ.

OPINION

At issue in this case is whether an insured party may lodge an appeal to court from an administrative decision denying insurance benefits for autism-related services.

Appellant, a six-year-old boy diagnosed with an autism-spectrum disorder, was receiving applied behavior analysis ("ABA"), a type of...

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