WASHINGTON, DC (December 19, 2012) -- Congress has agreed to require ABA care for all TRICARE beneficiaries with autism through a one-year pilot program, less than the permanent change sought by military families and Autism Speaks, but an important step forward for improved care. The measure, included as an amendment to the new defense authorization bill, will be resubmitted to both houses of Congress for final approval, and then goes to President Obama.
“Autism Speaks applauds the hard work of Senator Kirsten Gillibrand (D-NY) and Rep. John Larson (D-CT) in achieving this progress for the23,000 military families caring for loved ones with autism in a difficult budget climate,” said Karen Driscoll, Autism Speaks’ associate director for federal government affairs and military relations. “Our ultimate goal remains permanent coverage for all military families at appropriate care levels. We will closely monitor implementation of the one-year pilot program by the Department of Defense (DoD).”
Members of the armed services now receive ABA coverage for their dependents under the DoD’s TRICARE insurance program only if they are serving on active duty. The benefit is limited to $36,000, covering just 6 to 11 hours of therapy a week, well below the recommended level of care.
Both the House and Senate had approved bipartisan amendments to the new defense authorization bill requiring coverage for military retirees, in addition to active duty members, and provided for recommended levels of care consistent with best practices. The Senate version went further by incorporating the Coast Guard, the National Oceanic and Atmospheric Administration and the U.S. Public Health Service.
When the House and Senate met in conference committee to reconcile their two bills into a final version, the members noted their awareness of ongoing litigation in which the U.S. District Court ordered TRICARE to provide ABA benefits to all service members as a medical treatment.
“The conferees understand that the plaintiffs and DOD have each submitted motions to reconsider the court order,” the conference committee reported. “The conferees have provided DOD this one-year authority in order to allow DOD to assess such coverage independent from litigation proceedings."
The one-year pilot program is to start within 90 days of enactment of the new DoD authorization bill. Within 270 days, DoD will then be required to report to Congress on costs and any recommended legislative remedies.
Autism Speaks will closely monitor the DoD’s implementation of the pilot program on a variety of fronts, including its coverage of ABA Technicians and BCaBA’s.
“Autism Speaks expects the DoD to deliver improved services for military families under the pilot program,” said Driscoll. “We also expect TRICARE to work closely with military families to develop effective strategies that deliver real help to their kids. The pilot program must be a collaborative effort.”