Insurance Cuts in Indiana

The Indianapolis Business Journal reports:

Indiana boasts one of the highest concentrations of autism-focused therapists and even sports a new magazine, Autism Companion, supported by advertisers and subscribers in Indiana. 

“I didn’t even go out and do any market research at all because the demand was so great,” said Jane Grimes, who, before starting the magazine in 2013, was enrollment director at the Applied Behavior Center for Autism, which is expanding to six locations around the state. 

But now Indiana’s autism therapists say their prospects are cloudier after the state’s largest health insurer, Anthem Blue Cross and Blue Shield, cut payments 40 percent and took a harder line on paying for therapy for school-age children. 

One Indianapolis therapy provider, The Hope Source, nearly closed its doors in March because it couldn’t make payroll, although its finances have since rebounded a bit. Most other therapists have cut staff or services. 

For most autism therapists, the Anthem changes began two years ago, when the Indianapolis-based insurer said children age 7 and older need to receive a chunk of their autism therapy from public schools, as state and federal laws for disabled Americans requires. 

“Anthem cannot duplicate coverage for services that are available through the public school system,” Anthem stated in a May 2012 letter to parents of autistic children. The letter reiterated Anthem’s commitment to provide coverage for autism therapy. It has physicians review therapists’ treatment plan for each patient and, while it might deny some of the proposed terms, rarely issues a complete denial of coverage.