Major Overhaul Urged for Medical Care for Military Kids

WASHINGTON, DC (October 5, 2013) -- Autism Speaks has joined the American Academy of Pediatrics, Children's Hospital Association, Easter Seals and other major advocacy groups in their appeal for TRICARE to overhaul its pediatric care for military kids, including the delivery of applied behavior analysis (ABA) therapy.

The Department of Defense (DoD), which manages the TRICARE healthcare program for active and retired military members, was directed last year by Congress to conduct a comprehensive review of its pediatric care services. TRICARE now bases its reimbursement system on Medicare, which was established for adults aged 65 and older. 

"Children’s health care needs, however, differ from those of adults," Autism Speaks said in its letter to the DoD. "In its recent policy statement, the American Academy of Pediatrics (AAP) describes the problems with adult-based assumptions, and recommends healthcare policies reflect pediatric specific principles and address the unique needs of children when defining medical necessity."

These needs are heightened for military children with chronic medical conditions and disabilities.

Autism Speaks recommended four specific changes to TRICARE's pediatric services program. TRICARE should

  • Amend regulations and policies to reflect pediatric-specific principles
  • Improve access to pediatric specialty care providers
  • Emphasize family-centered care coordination
  • Improve coverage of applied behavior analysis

Autism Speaks has worked with its champions in Congress to expand TRICARE's ABA benefits to meet the needs of all beneficiaries including non-active duty members. Legislation to affect the change has cleared the House of Representatives and soon will be taken up by the Senate.

In addition to Autism Speaks and AAP, comments were submitted by: