The implementation of TRICARE (formerly known as the Civilian Health and Medical Program of the Uninformed Services, or CHAMPUS), began on January 1st of 2017, and has already begun to send families—particularly families of Autism—into a bit of a panic.
As military families struggle to decipher the changes that will occur under the new TRICARE, they’ve begun to realize one of the most heavily impacted treatments will be ABA (Applied Behavior Analysis), a highly-effective behavior therapy for children suffering from Autism.
At the surface, TRICARE has much stricter credentialing requirements for ABA providers than your average insurer, but that’s only the tip of the iceberg.
Mandy Farmer, a military wife and Autism-mom, wrote about TRICARE at From the Bowels of Motherhood:
“That’s not the worst of it. The policy that most worries providers and families alike is the new requirement that already diagnosed kids will need to have diagnosing evaluations re-administered every two years to continue services. The evaluations must be administered by an autism diagnosing specialist, many of whom have waitlists 12-24 months long for an initial evaluation. And many of whom will not entertain the idea of taking up a valuable 2 hour evaluation slot for a child who already has a diagnosis when so many kids are awaiting initial diagnosis so they can start receiving services. The new requirement that seems to be seeking a new diagnosis for a lifelong disorder has everyone pretty confused.”
Military healthcare facilities pleaded with TRICARE to reconsider, but the program proceeded with the new policy anyway.
And this isn’t the first time TRICARE and the DoD slashed services to Autism patients.
Farmer notes on her blog that reimbursement rates were cut in half in 2014.
The hope is that these poorly-designed policies will be reconsidered, however the military autism communities are encouraging Americans to reach out to their Congressmen and Senators to plead the case for Autistic children as well.