The Department of Defense has announced plans to consolidate its three different ABA programs under TRICARE with a new "Autism Care Demonstration" for all TRICARE beneficiaries with autism spectrum disorders.
The announcement was made in the Federal Register, but provided few details on how the new program would work. The new program would replace a one-year pilot program that expires next month, and incorporate two other plan offerings providing coverage for applied behavior analysis (ABA) treatment.
The action comes as Congress considers measures requiring TRICARE to improve ABA benefits, reduce restrictions on access to care, and make the treatment available to all children with developmental disabilities, not just autism.
The Autism Care Demonstration program would start July 25 and run through 2018. The new demonstration allows coverage of BCBA/BCBA-D direct services and the tiered service delivery model, which includes BCaBAs and Behavior Technicians. The demonstration will be phased in, enabling regional contractors to work with beneficiaries to ensure a smooth transition and avoid disruptions in services. Cost-sharing requirements for parents appear unchanged.
TRICARE’s website states that ABA services under the program will not be subject to annual dollar caps on care. Visit TRICARE's updated autism services page here.
The implementation and policy details of the new demonstration have not been published yet; Autism Speaks will provide additional analysis as more information is provided.