Anthem backs away from cutting autism payments

Anthem building in Indianapolis. (WTHR Photo)
Published:
Updated:

INDIANAPOLIS (WTHR) - Anthem Insurance is backing away from cutting payments for autism therapy....at least for now.

A week after 13 Investigates reported on the cuts to Applied Behavior Analysis, the company said it has made the decision to reinstate the rates for the two ABA therapies that were decreased in July, to the previous rate.

But on December 1, the rate for one of the ABA therapies will go from $15/unit to $12.25/unit, an adjustment that is less than the original decrease. Rates for the other code will not be reduced, according to Tony Felts, Anthem Spokesman.

The news comes as the state of Indiana joins a nationwide call for more Autism funding and research.
13 Investigates Reporter Sandra Chapman reveals why there is a new focus on the high numbers of minority children now diagnosed with Autism.

Life for Cherissa Clardy and her five year old daughter Kaelani was like a scrambled puzzle.

There was frustration, meltdowns and a revolving door of childcare centers.

"Probably 6 or 7 different daycares," revealed Clardy. "The last daycare that she was at, she was there for 3-hours before they said, 'We can't help her.'"

In crisis, Clardy set up an emergency appointment with her pediatrician. It wasn't until then she began to learn what was really going on. She learned her daughter was diagnosed with Sensory Processing Disorder, Opposition and Defiance Disorder and she was on the autism spectrum.

"That was the last diagnosis I was expecting," Clardy told 13 Investigates. "This is the piece that we've been missing this whole time," she added.

Kaelani is now among the growing number of minority children diagnosed with Autism.

"She is high functioning and academics is not necessarily her challenge, but socially, she really struggles," explained Clardy.

Overall at least 1 in 59 children are diagnosed with the disorder each year.
According to national research, the number is spiking due to a growing diagnosis among Hispanic, African American and Indian populations.

It's also why 47-states, including Indiana, are calling on Congress to support the Autism CARES Act of 2019. The proposed law provides more funding for research and programs to help identify children in minority communities sooner.

Cherissa hopes it will help to eliminate stigmas and bring more understanding about Autism.

"The more resources we have the better," Clardy said with a smile.

It's good news for Vivian Cain, the director of one of the state's first Montessori programs using Applied Behavior Analysis.

"Here, being alternative is our mainstream. It allows us to love and accept kids for who they are," said Cain.

The Montessori Program also provides a new start for Cherissa and her daughter.

"It excites me. It makes me very hopeful," said Cherissa.

The Autism CARES Act of 2019 also focuses on employment for young adults with autism.

Nearly half of 25-year olds on the Autism spectrum have never been employed.

The idea is to create more community based opportunities that give high functioning adults with the disorder more independence.

The Act calls for $370-million dollars in spending over a four year period beginning in 2020.

The Indiana Attorney General and the Mississippi Attorney General have been appointed represent the 47 states and help lead the act through Congress.

Filed under: