This is to be expected as mandates across the states now start to take effect. “Creative” maneuvering by the insurance companies is going to delay, defer, or deny coverage for ABA as much as possible due to the effect on their bottom line. ABA costs money. A lot of money. Most families in states who have recently passes autism mandates already know this and are going broke providing ABA and other interventions to their children with autism.
This article is not surprising though. Insurance points at the schools and says, “This is a governmental, educational problem.” The schools point at insurance providers and say, “This a medical problem and the insurance companies are responsible.” Unfortunately, parents are left in the lurch.
Gamesmanship will be played full swing as the statistics of autism increase, mandates are put to the continued observance and execution test and providers try to manipulate their insured with lunatic requirements that realistically can’t be met – such as is the case in Michigan.
Having lived in Michigan, I can attest to the shortage of providers and the long waiting lists for services. I can’t imagine how families who qualify for the mandate will jump through the hoops that insurance providers are creating. It is sad as well as disconcerting, and I hope that some semblance of enforcement of plausible terms can be created.
“A state law requiring insurance companies and health plans to pay for treatments for children with autism goes into effect today, but autism advocates and parents say that while the new measure is a significant step, many families may get little, if any, help from the new statute anytime soon.
Michigan has far too few medical professionals who offer the specialized therapy autistic children require, they say, and some insurers appear to be setting conditions that could make autistic children and their families wait many months for help — if they get it at all.
In the meantime, families with autistic children either go without the treatment that can help their sons and daughters learn to function, or teeter on the brink of financial ruin…”