Tuesday, December 20, 2011

Blue Cross change concerns patient advocates for autistic children - TwinCities.com

Blue Cross change concerns patient advocates for autistic children - TwinCities.com

Blue Cross and Blue Shield of Minnesota will begin dropping coverage in most cases for a costly therapy for autistic children as early as Jan. 1 - a change that has patient advocates worried about losing coverage through a key state program, too.

The Eagan-based health insurer said Monday that the coverage change will be phased in over next year and affect about 200 children who have been receiving a treatment known as early intensive behavioral intervention. The treatment cost averages about $80,000 per year.

Autism is one of four developmental disabilities grouped under the heading of Autism Spectrum Disorders, which can cause significant social, communication and behavioral changes. The federal government estimates that an average of one in 110 children in the United States have one of the disorders.

Blue Cross is changing its coverage policy to match that of other health plans as well as the state Department of Human Services, said Pam Lux, a spokeswoman for the insurer.

That's bad news, patient advocates said, because Blue Cross has been one of the few health plans to provide coverage of the intensive therapy, which in some cases involves 40 hours per week of treatment.

But the insurer's reference to the Department of Human Services also is concerning, advocates said, because the state has been a key source of coverage for families that don't have Blue Cross coverage.

"We're concerned that this is a harbinger of something on the horizon

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