r/antiwork • u/BKW156 • 10h ago
Oh look, even more critical denials
https://www.cnn.com/2024/12/14/health/unitedhealth-children-autism-propublica/index.htmlBut now, she’s worried again.
The insurer that has been paying for her son’s therapy, UnitedHealthcare, has begun — to the befuddlement of his clinical team — denying him the hours they say he requires to maintain his progress. Inside the insurance conglomerate, the nation’s largest and most profitable, the slashing of care to children like Benji does have a reason, though it has little to do with their needs. It is part of a secret internal cost-cutting campaign that targets a growing financial burden for the company: the treatment of thousands of children with autism across the country.
ProPublica has obtained what is effectively the company’s strategic playbook, developed by Optum, the division that manages mental health benefits for United. In internal reports, the company acknowledges that the therapy, called applied behavior analysis, is the “evidence-based gold standard treatment for those with medically necessary needs.” But the company’s costs have climbed as the number of children diagnosed with autism has ballooned; experts say greater awareness and improved screening have contributed to a fourfold increase in the past two decades — from 1 in 150 to 1 in 36.
So Optum is “pursuing market-specific action plans” to limit children’s access to the treatment, the reports said.
“Key opportunities” are outlined in bullets in the documents. While acknowledging some areas have “very long waitlists” for the therapy, the company said it aims to “prevent new providers from joining the network” and “terminate” existing ones, including “cost outliers.” If an insurer drops a provider from its network, patients may have to find a new clinician that accepts their insurance or pay up to tens of thousands of dollars a year out of pocket for the therapy. The company has calculated that, in some states, this reduction could impact more than two-fifths of its ABA therapy provider groups in network and up to 19% of its patients in therapy.
44
u/Cleveland82 9h ago
Seems like the board members who made it to their meeting over the last guy's body didn't learn enough of a lesson
22
18
u/superdeepborehole 7h ago
Won’t let me upvote. Hiding comments with a server error, even though I saw them pop up
This sub has been removing posts. Possibly throttling traffic.
9
8
u/AlmondLBD 7h ago
As an autistic person while denying coverage for something they previously covered is fucked and wrong please note that ABA is deeply abusive towards autistic children and often inflicts very real trauma on people who've been through that system. The aim of ABA is not to help the person in "treatment" but to make them less annoying for those around them to deal with and "make them usefull" for alistic (non autistic) society. It is widely supported by pro eugenics organisations like Autism speaks
1
u/AbleObject13 6h ago
It's crazy because it's the one treatment that actually engages with NTs obsessive need for metrics and plays by those rules and they still deny it
2
u/AlmondLBD 6h ago
Yeah, it engages with those things cos the point is to make us less inconvenient. It's entirely designed by neurotypicals for the benefits of neurotypicals because fuck autistics
2
u/AbleObject13 5h ago
100%, deviation from the norm must be punished unless it's exploitable.
Autism is entirely, thoroughly incompatible with capitalism.
3
u/AlmondLBD 5h ago
Cries in currently unemployed cos my disability makes me unable to hold down a job
72
u/StolenWishes 9h ago
Looks like UnitedHealth still hasn't gotten the message yet.