Tricare Changes Would Limit ABA for Military Families

Tricare change will impact more than 23,000 military children with autism

Starting July 25, Tricare is requiring children with autism to undergo standardized testing every six months and show measurable progress in order to receive applied behavior analysis therapy(ABA). Patients will also have to apply for Tricare waivers if treatment stretches beyond two years and for children older than age 16.

Patients that fail to make progress or show sustainable gains could be discharged from the intensive treatment.

The change has drawn the ire of Sen. Kirsten Gillibrand, D-NY, a member of the Senate Armed Services Committee, and Patty Murray, D-Wa., a member of the Senate Veterans’ Affairs Committee. The two questioned the provision that cuts off care for children who do not show progress during a six month period.

The Tricare change will impact more than 23,000 military children, many of whom face unique challenges due to relocation and dealing with deployments

The Tricare change has drawn the attention of Autism Speaks, an autism advocacy and research group. The new requirements will limit access to ABA therapy for children, Autism Speaks officials said, adding administrative changes could also reduce the number of healthcare providers accepting Tricare.

“These policies drastically change how ABA is covered under Tricare and will impact all beneficiaries and service providers,” said Karen Driscoll, Autism Speaks’ associate director for federal government affairs and military relations. “Autism Speaks is very concerned about the imposition of age and duration limits, threatened cutoffs for treatment, and the administrative hurdles to access care.

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