On July 18, the Department of Defense (DoD) announced that its new restrictions on Applied Behavioral Analysis (ABA) for the 23,000 military kids with autism will only apply to non-active duty members covered under the Extended Care Health Option (ECHO) program or TRICARE Basic. On July 21, DoD issued further guidance stating that the new restrictions would also apply to active duty family members receiving ABA after July, 25, 2013. The ABA coverage restrictions will now apply to a pilot program for the families of non-active and retired personnel and to active duty family members receiving ABA after July, 25, 2013. The pilot program, created in section 705 of the 2013 National Defense Authorization Act, was intended to study the feasibility of coverage for the treatment of Autism Spectrum Disorders (ASD) by comparing coverage under the TRICARE and its ECHO Program. (TRICARE is the military’s health care program for active duty, activated guard and reserves, retired members of the uniformed services, their families, and survivors. It does not cover ABA services. TRICARE’s separate ECHO program provides coverage for military family members with disabilities. While ECHO covers ABA services for ASD, the program is limited to active duty military and has an annual coverage cap.)
The proposed changes, scheduled to take effect July 25, require parents to arrange standardized testing every six months for their children in order to continue receiving care, and demonstrate “measurable progress.” The Arc will advocate for the removal of the coverage restrictions for all active duty personnel and for the pilot program that was created to study the feasibility of providing a comprehensive ABA benefit to children of military personnel in both the Tricare and ECHO programs. For more information on the proposed policy changes, see the letter from Senators Kirsten Gillibrand (D-NY) and Patty Murray (D-WA).