Obama Signs Bill with TRICARE Provision

Previous posts have discussed a measure enabling retired TRICARE enrolees to get coverage of ABA.  Autism Speaks reports:

President Obama has signed bipartisan legislation creating a one-year pilot program expanding ABA care to all military families through TRICARE, the Pentagon's healthcare program, a critical first step in improving services for military families raising children with autism.

"Autism Speaks thanks President Obama for taking this sensible step for military families, along with our Congressional champions Rep. John Larson of Connecticut and Sen. Kirsten Gillibrand of New York," said Peter Bell, Autism Speaks executive vice president for programs and services. "At the same time, we restate our intention to make these medical services permanent. Military families who sacrifice so much deserve access to the benefits they have earned."

The TRICARE provision was included as an amendment to the National Defense Authorization Act voted out of Congress in December. Both the House and Senate had approved a permanent expansion of ABA benefits providing for prescribed levels of care, but the measure was whittled down to a one-year pilot program when the bill was finalized in conference committee.

The Department of Defense (DoD) currently restricts ABA coverage to active duty members through the supplementary ECHO program which limits annual benefits to $36,000, covering just 6 to 11 hours of therapy a week, well below the recommended level of care. Because of specific policy shortfalls, ABA care terminates upon retirement, including services for children of wounded warriors retired due to injuries sustained in combat.

Service members have said they have re-enlisted for additional tours of duty simply to maintain coverage for their children with autism.

The one-year pilot program, which is for all TRICARE eligible beneficiaries with autism, is to start within 90 days. Within 270 days, DoD will then be required to report to Congress on costs, a comparison of the pilot program with ECHO and any recommended legislative remedies. The legislation offers no guidance on coverage limits or parameters of the program.

"Autism Speaks will closely monitor the DoD’s implementation of the pilot program on a variety of fronts, including its coverage of ABA Technicians and BCaBA’s," said Karen Driscoll, Autism Speaks’ associate director for federal government affairs and military relations, and a Marine Corps spouse.

"Development of effective policy is essential," she said. "It is critical that TRICARE work with stakeholders, including military families and subject matter experts, to ensure the final policies regarding coverage and delivery of ABA care are consistent with best practices."