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Wednesday, December 2, 2015

TRICARE Reimbursement Cuts

In The Politics of Autism, I write about ABA.
Specialists providing autism care to military families will face a pay cut in the spring, Tricare officials announced Tuesday, as reimbursement rates are reduced by as much as 35 percent for providers in certain locations.
Providers of applied behavior analysis therapy are currently reimbursed at a fixed rate based on education and certification level, regardless of location. Providers with a doctorate or master's degree are paid an hourly rate of $125, those with a bachelor's degree, $75; and technicians, $50.
Under the new plan, the national hourly rate will be set at $114.23 for doctors, $107.14 for those with a master's, $67.39 for those with a bachelor's and $40.12 for technicians. The rates will then be adjusted based on a geographic rate calculation used by Medicare.
Patricia Kime reports at Military Times:
The move will increase reimbursements for some therapists while trimming rates for others, but DoD officials said the changes should not affect the nearly 10,000 Tricare beneficiaries who receive Applied Behavior Analysis therapy for autism symptoms.
Tricare consolidated its various ABA therapy benefit programs in 2014 to ensure that active-duty and retiree dependents with autism had access to treatment.
But the new Autism Care Demonstration Project also proposed slashing reimbursement rates to some providers by nearly half, prompting some to say they would no longer accept Tricare.
DoD postponed implementation of the severe cuts, contracting instead with the Rand Corp. and a health policy research firm to help determine whether the level of coverage for ABA in the military health system was appropriate.
The new reimbursement rates — 20 percent higher than Medicaid's rates for ABA — are a result of those reviews.