Press Release:
WASHINGTON, D.C. Senators Thom Tillis (R-NC), Kirsten Gillibrand (D-NY), Bob Casey (D-PA), Roger Wicker (R-MS), Amy Klobuchar (D-MN), and Chris Murphy (D-CT) sent a letter to the Chairmen and Ranking Members of the Senate and House Appropriations Committee urging funding to be included in the final version of the FY 2017 Department of Defense Appropriations Act to reverse cuts to reimbursement rates for Applied Behavioral Analysis (ABA) treatment for military children with Autism Spectrum Disorder (ASD) to ensure they can continue to receive care under TRICARE.
TRICARE is a managed health care program for active duty, reserve component and retired members of the uniformed services, their families, and survivors. TRICARE began a demonstration project last year to provide a single, uniform benefit to the estimated 26,000 TRICARE beneficiaries with ASD. However, in April, TRICARE adjusted the reimbursement rates to providers of ABA therapy threatening a severe reduction in access to crucial ABA services for dependents with ASD. The Senators called on the committees to ensure the final appropriations for the Department of Defense include a reversal in the TRICARE cuts to mirror this reversal in the House and Senate National Defense Authorization Act bills.
"ABA therapy is an intensive one-on-one therapy usually conducted at the home of the recipient. One of the objectives of the demonstration program was to provide a single, uniform benefit to the estimated 26,000 TRICARE beneficiaries with ASD, and approximately 40% of eligible beneficiaries receive ABA services under this program," the Senators wrote.
"We request that you include $32 million in the final appropriations bill that provides funding for the Department of Defense for FY 2017. These funds will ensure that military children with ASD in need of therapy can obtain the services they and their families deserve."
Read the full text of the letter below or download it here.
October 3, 2016
Dear Chairmen Cochran and Rogers and Ranking Members Mikulski and Lowey:
We urge you to include funding in the final version of the FY 2017 Department of Defense Appropriations Act (H.R. 5293) that would allow military children with Autism Spectrum Disorder (ASD) to continue receiving Applied Behavioral Analysis (ABA) treatment under TRICARE.
Currently, TRICARE beneficiaries with ASD receive ABA therapy under the autism care demonstration program, which began on July 25, 2014 and is slated to end on December 31, 2016. ABA therapy is an intensive one-on-one therapy usually conducted at the home of the recipient. One of the objectives of the demonstration program was to provide a single, uniform benefit to the estimated 26,000 TRICARE beneficiaries with ASD, and approximately 40% of eligible beneficiaries receive ABA services under this program.
Effective April 1, 2016, the Defense Health Agency (DHA) adjusted TRICARE reimbursement rates to providers of ABA therapy. These new reimbursement rates were based on two DHA-commissioned studies, by RAND Corporation and Kennell and Associates, and adjusted for localities. Although some geographic areas, such as large metropolitan areas, saw an increase in reimbursement rates, many locations saw dramatic cuts. Military bases, many of which are located in suburban or rural areas, witnessed substantial decreases in reimbursement rates. These cuts were imposed despite indications from various parts of the country that there were ABA provider shortages, and in some locations, no providers at all. Both before and since the April 1 rate cuts, military families are confronting ABA provider shortages in Washington State, Fort Hood and Fort Bliss, TX; Fort Riley and Fort Leavenworth, KS; Wright Patterson AFB, OH; Fort Bragg, NC; Fort Benning, GA; and Fort Campbell, KY.
Both military families and providers are displeased with these reduced reimbursement rates. Furthermore, a large group of stakeholders have also stated their opposition to DHA's cuts for ABA services for military children, including Autism Speaks, Easter Seals, the National Military Family Association, the TRICARE for Kids Coalition, Military Officer's Association, Children's Hospital Association, and the San Diego Military Advisory Council.
In light of these cuts to reimbursement rates and associated shortages of providers, an amendment to H.R. 5293 was proposed and adopted by voice vote on the House Floor, providing $32 million to reverse the cuts in reimbursement rates to providers of ABA services to military dependents with ASD that the DHA implemented on April 1, 2016. Of note, both the House and Senate versions of the National Defense Authorization Act (NDAA) for FY 2017 included language that would reinstate the reimbursement rates to ABA providers that were in effect as of March 31, 2016. In addition to supporting the will of Congress, the $32 million in appropriations would help preserve the success of the autism care demonstration program.
We request that you include $32 million in the final appropriations bill that provides funding for the Department of Defense for FY 2017. These funds will ensure that military children with ASD in need of therapy can obtain the services they and their families deserve.
Sincerely,
Senator Kirsten Gillibrand
Senator Thom Tillis
Senator Robert P. Casey, Jr.
Senator Roger F. Wicker
Senator Amy Klobuchar
Senator Christopher S. Murphy
- Contact: Daniel Keylin
- daniel_keylin@tillis.senate.gov
