Insurance dispute could mean CNY children with autism lose coverage for therapy

CLAY, N.Y. (WSYR-TV) — Jumping for joy isn’t just an expression for Dakota Flowers.

“Ready? Show them how high you can jump,” Dakota’s father, David Flowers, said as he helps her onto the trampoline. “She loves it.” 

Flowers said Dakota is happiest when she’s bouncing.

The eight-year-old doesn’t speak. She has autism and communicates through movement or using a speech-generating device.

“It’s repetition, it’s routine, Flowers said.

And following a routine is something that Flowers said is very important.

Right now, Dakota goes to autism therapy every day after school for two and a half hours.

“They work with them. They do things that the school doesn’t have the funds to do to provide for the kids,” Flowers added.

The behavioral health center is called Proud Moments – but Flowers calls it his life saver.

“[Applied Behavior Analysis] has been proven to help kids with autism progress in their everyday life,” Flowers said.

Dakota’s been going to Proud Moments in Syracuse for the last five years. And Flowers’s insurance – Anthem Blue Cross and Blue Shield – has always covered the cost. That’s why he was shocked when he got a letter telling him that come the end of the month, Proud Moments would “not be able to continue services” for his daughter.

“What was going through your mind when you read that letter?” NewsChannel 9’s Rachel Polansky asked. 

“Dakota. Dakota. What am I gonna do to provide her the services that she deserves?” Flowers asked.

According to a complaint Proud Moments filed with the state, Anthem has not paid them for more than $12 million dollars’ worth of services. 

The complaint goes on to say: “The failure to make timely payments is putting in jeopardy the children…that are in our care.”

And it’s not just the Flowers’ family who is impacted by this insurance dispute.

Proud Moments said it plans to discontinue services for roughly 120 families who use Anthem Blue Cross and Blue Shield. At least 80 of those families live in New York.

“It’s a big deal,” Flowers said.

 A big deal that Flowers said will limit dozens of children like Dakota, from reaching new heights.

A spokesperson for Anthem Blue Cross and Blue Shield tells NewsChannel 9: “At Anthem, we value our collaborative relationships with New York’s care providers. We are working with Proud Moments to resolve some concerns, but we cannot comment further while those discussions are ongoing.”

If the dispute does not get worked out, Proud Moments will be discontinuing services for families with Anthem Friday, April 26.