Tuesday, October 27, 2009

Ruling deals a blow to denials of autism treatment -- latimes.com

Imagine this. Your child has suddenly stopped talking. You have talked to your doctor who has told you to get him to a speech therapist for an assessment IMMEDIATELY. You are panicked because you have no idea what has happened. You call your health insurance carrier customer service line. You tell the representative, that your child has stopped talking and you need a referral to a speech therapist. The representative says "What's his diagnosis?". You say "I don't know he stopped talking". The representative says "I cannot do a referral without a diagnosis mam". You say, "I don't have a diagnosis, it has been suggested that I also get an assessment for autism", you break out into tears. The representative says "Oh, autism? Please hold". You wait, feeling; scared, shaking, angry, frustrated, hopeful. The representative returns to the line after 3 minutes and says "I'm sorry we don't cover speech for autism". You cry and yell "What do you mean, my son has stopped talking. He can't talk. He needs help,what do you mean you can't help?!"

With what seems like total indifference the insurance representative calmly and briefly replies "Sorry mam. Is there anything else I can help you with today?".

This is when my battle with medical insurance began. I could not believe that they were unwilling to help us, but they were. Nine years later progress is being made, slowly. Some states have passed laws requiring insurance company's to cover medically necessary treatments for people with Autism, others including CA are still in the battle. Today CA took one step closer to forcing the insurance company's to provide medically necessary coverage and it made the Los Angeles Times.

Here is an excerpt from the article that sums it up for me!

Consumer Watchdog President Jamie Court said the ruling was reason enough for Gov. Arnold Schwarzenegger to order the department to stop fighting the suit and start ordering insurers to provide the treatment to their autistic members.

"For an administration that is so involved with the Special Olympics to not understand the harm it's causing every day that an autistic child doesn't get the care they need is not only legally inexcusable but morally reprehensible," Court said.



Ruling deals a blow to denials of autism treatment -- latimes.com

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3 comments:

  1. Donna
    Thank you so much for putting the effort in spreading the word!
    This is a terrible injustice that is being done to the children in our lives. You are such a great advocate for Nicky...Thank you for all that you do....

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