Statesboro mother fears Medicaid cut could reduce her twins’ autism therapy

Statesboro, Ga. (WTOC) - A mother of two twin boys, both who were diagnosed with autism and receive ABA therapy, is reeling, as potential of losing insurance coverage of critical therapy hours looms over her head.

Brianna Hackett, a Statesboro mother, said she received a letter warning that one son’s therapy hours may be cut. The boys, Mayson and Grayson, have both received applied behavior analysis, or ABA, therapy for about a year. Hackett said their communication skills have changed significantly during that time.

“Just the progress. Not being able to talk to them to now I can hold full conversations, it’s such a big deal,” Hackett said.

She recalled crying at times because she once wondered whether she would be able to communicate with her sons.

“I found myself crying a lot sometimes just because I never thought I would be able to communicate with my boys,” she said.

Mother worries about losing progress

Hackett said she is concerned that a reduction in therapy could interrupt the consistency her sons need. She said one of her children went six months without banging his head on something and fears that some behaviors could return if services are reduced.

“I have went six months watching my baby not bang his head on something. So to go back to that or to go back to, you know, just certain behaviors because the consistency is not there, that would be so hard,” Hackett said.

She said decisions about reducing services should account for how the changes could affect children and their families.

“Oh well, we have to make cuts somewhere, but it’s not just about making the cuts. It’s about how are you going to affect the children,” Hackett said.

Regional director says insurers are reducing hours

Families across the Coastal Empire who rely on ABA therapy may face reduced coverage or, in some cases, lose all coverage, according to Kelsey Laflin, an ABA regional director.

Laflin said insurance companies, particularly Medicaid, have been reducing the number of approved therapy hours and sometimes cutting services altogether. She said the reductions began after findings that some providers had improperly charged and billed insurance companies.

Laflin said insurers may reduce services even when providers submit evidence that therapy is helping children progress.

“Not wanting to pay for it, so reducing services as much as they can, even when it’s not medically supported by the evidence that we can provide on why these services really are helping the children progress,” Laflin said.

She said insurance companies do not see the day-to-day changes providers witness, including children’s growth and first spoken words.

“The insurance companies don’t see what we see day-to-day, which is the smiles and the laughs and the growth and hearing kids, you know, speak words for the first time,” Laflin said.

ABA therapy and assistance options

ABA therapy is used with children with autism to help them develop behavioral, social and other life skills.

Laflin said paying for services out of pocket would not be feasible for 98% of her patients.

Families who receive a similar notice that their coverage may change can look into the state’s Family Support Services Program and Easterseals of Southern Georgia.