In March, the Defense Health Agency, which oversees TRICARE, announced that by May, advanced behavioral analysis services outside of clinical settings will no longer be covered by the military insurance.
Prior to the TRICARE changes, technicians could accompany children with autism to school and help facilitate the child’s learning.
According to a July news release from TRICARE, behavior technicians were reclassified as non-clinical, thus not covered by the insurance, and as a result, not accompanying children into the classroom.
The release states a TRICARE contractor may authorize board-certified behavior analysts to provide time-limited clinical advanced behavioral analysis services for a child in the school setting.
[Fort Bragg combat veteran James] Martin compared the change to going to a doctor’s office that has no support staff, physician assistant or licensed practical nurse.
Community settings such as dental appointments or sporting events are no longer considered the space for behavior technician unless determined “clinically appropriate” based on a child’s treatment plan, the news release states.
Martin said it seems as if the Defense Health Agency is limiting services, which he said is causing applied behavioral analysis companies to leave Fayetteville.
“It feels like this new policy change was backdoored and was not in the best interest of the families concerned,” Martin said. “I know the government needs to budget, but going after services for disabled children with autism is a new low.”