TRICARE Worries

In The Politics of Autism, I write about applied behavior analysis (ABA).  A December 2 post noted a change in reimbursement rates for TRICARE, which serves military families.  At Stars and Stripes, Tom Philpott reports:

Megan Miller, a therapist with a doctorate who co-owns Navigation Behavioral Consulting, an ABA business in Virginia Beach, Va., said 80 percent of her clients are military children. Current Tricare rates, she said, support tiered services because current advanced degree provider fees are sufficient to cover hours when both a supervisor and technician provide care.

Because Tricare pays for only one provider at a time, the worry for some businesses is that lowered fees won’t support the tiered model, forcing them to use only advanced degree therapists, and not technicians who can’t always work alone. Overall availability of services could fall, Miller said.

On Dec. 1, the day Tricare announced plans for cutting ABA reimbursements, Miller launched an online email survey of businesses that are part of the Behavior Analysis Advocacy Network. It asked how the lowered fees would affect services to their Tricare beneficiaries.

Within a week, more than 100 businesses responded. Six predicted no impact. Seventy said they were still determining the effect. But 13 businesses said they no longer would provide services to Tricare families, affecting 350 children. Eight other companies said fee cuts potentially would affect Tricare clients only in certai