By Deborah Kotz, Globe Staff
Its been nearly two years since Massachusetts passed one of the strongest laws in the nation mandating that insurers provide coverage for the diagnosis and treatment of autism, without any annual or lifetime limits on the amount of coverage. Yet some of the states biggest employers -- including Boston University and Harvard -- dont provide coverage for therapeutic services that can cost families tens of thousands of dollars every year.
They dont have to under the states ARICA law because theyre self-funded plans that are regulated by federal law and not subject to state law. The federal government added autism coverage to its benefits package for federal employees last June.
Some Boston-area companies with self-funded plans such as Partners HealthCare, Tufts University, Iron Mountain, the Lahey Clinic, State Street Corporation, and Ocean Spray have opted to include autism coverage in their health plans. Others, though, seem to be dragging their heels.
Places like Harvard and BU dont provide coverage for their employees, but they were part of the [Autism] Consortium that testified in support of the state legislation mandating coverage, said Judith Ursitti, director of state government affairs at Autism Speaks, a non-profit advocacy and research group. Its ironic hypocrisy.
Boston University physics professor Anatoli Polkovnikov told me that he cant afford to pay the $3,000 per month for the behavioral therapy sessions that his 11-year-old son, Ilya, needs. We have Blue Cross Blue Shield, which covers speech therapy and physical therapy, but thats pretty much it, he said.
Ilya is at the low-functioning end of the autism spectrum. Although sweet-natured and not aggressive, Ilya has a range of behavioral issues such as wandering away from his parents at the mall, said his mother Irina. He needs to learn how to stay with us when were outside the house, how to spread butter on bread, how to bathe himself, and go to the bathroom, she added.
Research suggests that applied behavioral analysis or ABA therapy is one of the few effective therapies for teaching kids with autism such basic life skills. But the Polkovnikovs said it would cost them $102 for each two-hour session, and their son would require 10 hours a week. Thats in addition to the specialized schooling he gets through the Newton public schools.
Anatoli Polkovnikov said hes been through the rounds with the human resources department at the university, but to no avail, and now theyve stopped responding to his e-mails.
Boston University provides good and generous employee benefits, said spokesperson Colin Riley, though he confirmed the university does not provide coverage for autism therapies to its employees. We frequently review the benefits offered to see if we can improve them. Riley wouldnt predict whether autism coverage would be included in the future.
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Why can’t Harvard and BU employees get insurance coverage for autism therapies?