October 18, 2014
TRICARE To Decrease Autism Healthcare Payments, ASD Parents Worried They Will Lose Services

Military families that include children with autism are concerned that changes to TRICARE may result in a loss of professional help, according to The Hill. TRICARE is the U.S. military's healthcare plan. The Pentagon has been working to reduce costs of healthcare, and cuts in what TRICARE is willing to pay for board-certified behavior analysts for children with autism is in the plan.

The reports state that the Pentagon's new plan slashes payments to providers working with autistic children nearly in half. The TRICARE manual, which was issued in September, states that TRICARE will pay these care providers between $50 and $68 per hour. This is a significant decrease to the previous $125 an hour that TRICARE was willing to pay providers for some autism related behavioral services in the existing plan.

TRICARE records show that last year, 7,800 military children used benefits for autism-related behavior care.

According to The Hill, healthcare providers say they will not be able to provide services for autism at the proposed rates. Consequently, if TRICARE adopts the proposed rates, military families will likely lose autism-related services. Almost all providers surveyed by Navigation Behavioral Consulting said that they will be forced to reduce services offered to children with autism if TRICARE is only planning on paying the rates the Pentagon has proposed. Almost a quarter of the providers stated that they would have to stop providing services for autism to military children completely.

"These new changes to autism therapy could be game over for some of our military families around the country," board certified behavior analyst Amanda Kelly said.

The cuts were to go through October 20, but according to the Department of Defense, the changes have been postponed until April.

"TRICARE will continue to pay the previous rate of $125 an hour for one-on-one therapy with a board-certified behavior analyst rather than the new $68-per-hour rate."

The Department of Defense statement says that the new plan for children with autism also includes benefits that the old plan did not. For example, the new demo has no annual caps on payments. Previously there was a $36,000 annual cap. Also, in the new structure, there is no maximum age for benefits.

"The Department understands the concerns caused by the rate change. In order to address these concerns, the Department has commissioned an independent review of the Demonstration," a Department of Defense statement said, according to an article on Autism Speaks' blog about the changes to TRICARE.

[Photo via Texas State University]