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Monday, October 15, 2012

Limits of the Michigan Mandate

The Detroit News reports on the limits of the Michigan mandate:
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.
Blue Cross is putting up roadblocks:
First, children must be screened to confirm a diagnosis of autism and have a treatment plan at one of four medical centers in the state, all in Southeast Michigan, where the shortest waiting list already is four months long.
Second, according to one autism expert who's been in discussions with the insurer, Blue Cross plans to reimburse the certified behavioral therapists who'll provide the state-mandated Applied Behavior Analysis therapy $36 per hour for services. The expert, who asked not to be identified because discussions continue with Blue Cross, said such specialized therapists usually receive $50 to $125 an hour.