Tricare Comprehensive Autism Care Demonstration program<\/a> will expand to provide more support to meet the families\u2019 needs, according to an announcement March 30 by the Defense Health Agency, three days before World Autism Awareness Day on April 2. There are nearly 16,000 military children diagnosed with autism involved in that program.<\/p>\n\n\n\nThe demonstration project will continue to cover applied behavior analysis therapy, or ABA, services \u2014 which are available for all Tricare-eligible beneficiaries with autism spectrum disorder diagnosed by an approved provider. And Tricare will continue to cover telehealth services for ABA parental guidance and training beyond the pandemic, when the telehealth coverage began, according to the announcement. ABA therapy is a time-consuming, intensive treatment that encourages positive behaviors and discourages negative behaviors to improve a variety of skills.<\/p>\n\n\n\n
The autism care demonstration program started July 25, 2014 and has mostly focused on ABA services. The DoD changes will expand and combine all available services into one comprehensive care plan, officials said. The demonstration program is scheduled to end Dec. 31, 2023.<\/p>\n\n\n\n
\u201cWe remain committed to addressing the needs of those beneficiaries diagnosed with [autism spectrum disorder] and their families,\u201d said Dr. Krystyna Bienia, clinical psychologist and senior policy analyst at the Defense Health Agency, in the announcement. \u201cThere isn\u2019t a \u2018one size fits all\u2019 approach when it comes to ASD care. We want our beneficiaries to have options, and these improvements should help connect families with the right services at the right time.\u201d<\/p>\n\n\n\n
Starting May 1, Tricare will no longer require a periodic re-diagnosis to get continued care. Other changes are expected to roll out over the next nine months, and be in place by Jan. 1, 2022, officials said.<\/p>\n\n\n\n
Some advocates were concerned that DoD would cut back on the ABA therapy coverage with their revisions, following DoD\u2019s reports to Congress about the outcomes of the program. In their 2020 annual report to Congress DoD stated their findings \u201cdemonstrate that the current format of the [autism demonstration project], and the delivery of ABA services, is not working for most Tricare beneficiaries\u201d in the project.<\/p>\n\n\n\n
\u201cIt is imperative that [Defense Health Agency] take a deeper look into why Tricare beneficiaries are not seeing more improvement over time,\u201d the DoD report stated.<\/p>\n\n\n\n
A recent report was critical of DoD\u2019s interpretation of the data surrounding the measurement of children\u2019s progress under ABA.<\/p>\n\n\n\n
It\u2019s not clear whether there\u2019s been a change in DoD\u2019s position, but they have made clear they are continuing the ABA therapy coverage, and expanding services beyond ABA.<\/p>\n\n\n\n
Meanwhile, one of the new requirements is more frequent measurements of children\u2019s progress under ABA.<\/p>\n\n\n\n
Among the changes:<\/p>\n\n\n\n
*For those who enter the autism care demonstration program on or after Oct. 1, Tricare will assign an autism services navigator to work with the family to develop a comprehensive care plan and to coordinate care. The navigator can also connect the family to additional autism resources.<\/p>\n\n\n\n
*Telehealth benefits will continue. Parents will be able to get parental guidance and trainings through telehealth even beyond the national emergency due to the pandemic, when Tricare began covering these services through telehealth.<\/p>\n\n\n\n
*The provider will be allowed to bill Tricare for group services, if they are clinically appropriate.<\/p>\n\n\n\n
*Parents of children with autism will have greater involvement in the development of the child\u2019s care plan.<\/p>\n\n\n\n
*Tricare will no longer require a periodic re-diagnosis to get continued care. That means, in most cases, families aren\u2019t required to follow up with a specialist after the initial Tricare-approved diagnosing provider determines a diagnosis of autism spectrum disorder. Tricare recommends additional appointments with the specialist, however, to help ensure families consider all the clinical and non-clinical options.<\/p>\n\n\n\n
*More frequent outcome measures will be required \u2014 every year instead of every two years\u2014 but families won\u2019t have to go back to a specialist for these evaluations. The new one-year evaluation cycle takes effect July 1.<\/p>\n\n\n\n
Families will still need a referral and pre-authorization from a Tricare-authorized provider \u2014 a diagnosing provider and ABA provider \u2014to receive the services. The ABA provider must conduct an ABA assessment and develop an individual ABA treatment plan. Previously accessible case management services will remain available.<\/p>\n\n\n\n
Military special needs families \u201care still wading through the details of the changes,\u201d said Michelle Norman, executive director and founder at Partners in Promise. While some changes are positive, such as the autism services navigator employed by Tricare to help families, there are some concerns about data collection, and some restrictions on ABA in school and in the community. \u201cThere are definitely more requirements that add more to the plates of these families and it is not clear the requirements are \u2018helping\u2019 them,\u201d she said.<\/p>\n\n\n\n
The changes are a result of a review conducted by DoD officials, who in their most recent report to Congress, stated they intended to \u201cevolve the program to a more beneficiary- and family-centric model.\u201d Officials stated they aim to improve the quality of, value, and access to care and services for beneficiaries diagnosed with autism spectrum disorder and their families.<\/p>\n\n\n\n
According to that DoD report, costs for the ABA treatment in the demonstration project were $370 million in fiscal 2019. The average cost for the time-consuming, intensive treatment was $23,253 in 2019. Costs vary depending on the frequency of treatment and a variety of other factors.<\/p>\n","protected":false},"excerpt":{"rendered":"
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