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Wednesday, February 24, 2016


In The Politics of Autism, I discuss the day-to-day challenges facing autistic people and their families.

From Autism Speaks:
Applied Behavior Analysis (ABA) is an effective, evidenced-based treatment for ASD. In 2014 TRICARE, the Department of Defense (DoD) healthcare program for military servicemen and women and their families, implemented thoughtful and necessary changes to its coverage of ABA through its Comprehensive Autism Care Demonstration (ACD). In late 2015, TRICARE announced reimbursement rate cuts for ABA therapy provided through the ACD. The rate cuts were announced without supporting written analysis.
The details of TRICARE’s proposal have now been released. Autism Speaks is concerned that the rate cuts will reduce access to ABA services. Shortages of Board Certified Behavioral Analysts (BCBAs) already exist near Fort Campbell, Fort Sill, Wright-Patterson Air Force Base and other locations around the country. The DoD’s own studies indicate that TRICARE’s proposed rates for technicians are significantly below the national average. If adopted, the rate cuts might lead providers to leave TRICARE’s networks or give priority to children with other types of health insurance.
The reimbursement rate cuts risk a rollback of the substantial progress TRICARE has made in meeting the needs of military family members with ASD. Autism Speaks urges that reimbursement rates not be cut before the ACD is completed in 2018. At that time TRICARE should undertake a comprehensive analysis of ABA services, including reimbursement rates, to assure adequate coverage and access for TRICARE beneficiaries.
Amy Bushatz reports at
"The ABA treatment for persons with autism and the proposed rate cut is something that I'm concerned with the timing of," Sen. Thom Tillis, a Republican from North Carolina, told a panel of experts a Senate Armed Services subcommittee hearing this week.
"I think we may be making a mistake cutting treatment options below the national average and produce a bad outcome for something, I think, that has been proven to be highly effective and highly beneficial to those that take advantage of the treatment," he added.
Dr. Jonathan Woodson, the Pentagon's assistant secretary for health affairs, told the committee that Tricare is keeping a close watch on whether or not there are enough providers.
"Certainly we'll be monitoring the situation very closely, and should we find in any locality that it's been adversely affected, we will make rapid changes," he said.
Sill Sen. Kristen Gillibrand, a Democrat from New York, worried that the Tricare-ordered RAND study is "misleading."
"I have some specific concerns in regards to the studies and the methodologies, because I don't think they are reflective of the cost, so I'd like to request some follow-up information specifically on that, and further consideration, because I think it's inadequate," she told Woodson during the hearing. "I think your study is misleading in its outcomes … I'm very concerned that there will be negative consequences for patients."