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Changes to Anthem Blue Cross and Blue Shield’s Policies Reduce Autistics’ Access to Therapy

by on June 23, 2014
 

Anthem Blue Cross and Blue Shield, Indiana’s largest health insurer plans to make additional cuts to its coverage for autism therapies, including steep cuts to services implemented in 2001, when the state became the first in the U.S. to require health insurers to cover autism therapy in a meaningful way.

After an initial strong start with 2001 changes to Indiana’s insurance laws, Anthem initially started to make changes to reduce its autism therapy coverage:
  • In 2012, Anthem announced that children age 7 and older needed to receive a portion of their autism therapy from public schools, as required by state and federal law, and reduced covered therapy from 40 hours a week to as low as 20 hours.
  • According to a letter the health care provider sent to parents of autistic children in May of 2012, “Anthem cannot duplicate coverage for services that are available through the public school system.”
  • Then, in January 2013, Anthem cut reimbursements for applied behavior analysis therapy by 40 percent. Applied behavior analysis therapy is the leading approach to helping autistic children overcome their cognitive, social or behavioral deficits.
At this point, unsure of what additional cuts are to be made, many autism therapists and parents say they aren’t sure what the future holds. According to the IndyStar.com article, Anthem Blue Cross and Blue Shield’s cuts cloud future for autism therapists:
  • The Hope Source in Indianapolis nearly closed in March because it couldn’t make payroll. 85 percent of the Hope source’s clients are age 9 or older.
  • The Behavior Analysis Center for Autism (BACA) was forced to lay off 15 people, nearly 10 percent of its staff. BACA operates locations in Fishers, Zionsville and Elkhart, Indiana.

According to Carl Sundberg, BACA’s executive director, “If they were to cut again, we’re all done. The whole system’s done.”

For more information about this disturbing turn of events, a step backwards in the advances autism advocacy has made over the last few years, read the complete IndyStar article: Anthem Blue Cross and Blue Shield’s cuts cloud future for autism therapists. (opens in new window)