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Autism Care Demonstration, TRICARE Health Program
In an effort to continually improve the benefit, the Comprehensive Autism Care Demonstration (ACD) was recently updated to reduce the potential financial burden of applied behavior analysis (ABA) services for non-active duty families.
As of October 1, 2015, all ACD cost-shares will match TRICARE PrimeA managed care option available in Prime Service Areas in the United States; you have an assigned primary care manager who provides most of your care.TRICARE Prime and Standard cost-shares for all ABA services provided by authorized ABA supervisors, assistant behavior analysts, and behavior technicians. This change will allow cost-shares to contribute to the annual catastrophic cap for families and eliminates the 10 percent cost-share for assistant behavior analyst and behavior technician services, also known as “tiered” services, significantly reducing the potential financial burden of ABA services for our non-active duty families.
Revisions were also made to enhance the quality and safety of ABA services. All ABA providers will become trained in Basic Life Support (BLS) by December 31, 2015. Many beneficiaries diagnosed with autism spectrum disorder (ASD) typically have other medical conditions, and in the rare event that BLS would be needed to save a life, all ABA providers will be trained. All behavior technicians (BT) are also now required to obtain BT certification from an accredited organization. BT certification ensures these providers are consistently well-trained in ABA services.
The TRICARE ACD covers all TRICARE eligible beneficiaries diagnosed with ASD under a single benefit. There are currently almost 13,000 beneficiaries receiving ABA through the ACD which runs through December 31, 2018.
For more information about the changes to this benefit, visit the Autism Care Demonstration page on the TRICARE website.