► Blue Alert

Opt-in autism benefit available for Blues ASC customers

In July, we told you in a Blue Alert about the standard autism benefit and coverage and that BCBSM and BCN would soon provide coverage for the diagnosis and treatment of autism spectrum disorders.

Now, we’re filling you in on how to handle opt-in requests for ASC customers.

BCBSM opt-in lead times
Standard benefit requests should be submitted between Oct. 15, 2012, and Nov. 1, 2012, to ensure that benefits are active Jan. 1, 2013.  Follow the usual group-wide change process for submitting the benefit request.

There’s a 60-day lead time for both MOS and NASCO platforms if:

• The group selects the standard autism benefit with no modifications
• The group uses the Blue Cross behavioral management vendor for approval

For groups that require modification to the standard benefit, at least 90 days lead time is required.

Standard benefit requests must be submitted by Nov. 1, 2012.

BCN opt-in lead times

• For a Jan. 1, 2013 opt in standard benefit requests should be submitted no later than Oct. 15.
• For groups that require modification to the standard benefit at least 90 days lead time is required.
• Follow the usual group wide change process for submitting the benefit request.

Additional information
Blue Cross isn’t charging any fees to administer the benefit program. You can read more about the details here (PDF).

NOTE: This doesn’t include the state of Michigan Autism Coverage Reimbursement program to reimburse plans for claims paid for autism spectrum disorders services provided in Michigan. We’ll provide more information on the reimbursement program when the state issues its final guidance.

Questions? Contact your managing agent or Blues representative.

The information in this document is based on Michigan Blues’ review of the autism legislation and is not intended to impart legal advice. Interpretations of this legislation may vary, and efforts will be made to present and update accurate information. This overview is intended as an educational tool only and does not replace a more rigorous review of the law’s applicability to individual circumstances and attendant legal counsel and should not be relied upon as legal or compliance advice.