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Sunday, December 18, 2016

Tillis and Gillibrand Restore TRICARE Reimbursement Rates

In The Politics of Autism, I discuss the day-to-day challenges facing autistic people and their families.  As many posts have discussed, the challenges are especially great for military families.

U.S. Senators Thom Tillis (R-NC) and Kirsten Gillibrand (D-NY), members of the Senate Armed Services Committee, announced that the Senate has passed their provision that would address issues with reimbursement rates for the TRICARE Autism Care Demonstration program. The Department of Defense is currently implementing a demonstration project that is scheduled to expire in December, 2018 that provides access to Applied Behavioral Analysis therapy to all military dependents with Autism Spectrum Disorder (ASD). Gillibrand and Tillis’s efforts would reset reimbursement rates for providers to no less than the levels that were in effect on March 31, 2016 to ensure access to care for all military dependents with ASD. The provision passed the Senate as part of the Fiscal Year 2017 National Defense Authorization Act (NDAA) and now heads to the President for his signature.
"During the past year, Senator Gillibrand and I have been working across the aisle to help restore reimbursement rates for ABA providers, and I'm pleased our provision was included in the NDAA," said Senator Tillis. "I now look forward to working with appropriators in the House and Senate to ensure that we provide for our military families.”
“I am so pleased that we were able to come together and roll back these rates to ensure that providers continue to participate in the Autism Care Demonstration program and that our military families have access to the critical services, care and support they need and deserve,” said Senator Gillibrand.
In March, Tillis and Gillibrand urged the Defense Secretary in a bipartisan letter to delay the new rates until after completion of the Demonstration program to protect ABA therapy access for over 26,000 children of military personnel and retirees. The following month, the Defense Health Agency (DHA) moved forward with adjusting TRICARE reimbursement rates for ABA therapy to beneficiaries diagnosed with ASD. Although metropolitan areas saw an increase in reimbursement rates, military bases mostly located in suburban or rural areas saw drastic cuts and substantial decreases in reimbursement rates.

The Demonstration program was designed to combine three different TRICARE programs that covered ABA services for beneficiaries into a single program with one uniform benefit. The demonstration program would also expand access to these services among the 26,000 TRICARE beneficiaries with ASD.