Washington, D.C. – U.S. Senator Kirsten Gillibrand, a member of the Senate Armed Services Committee, announced that the Senate has passed her provision that would address issues with reimbursement rates for the TRICARE Autism Care Demonstration program. DoD 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’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 signature.
“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, 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.