Tillis: Postpone reimbursement rate cuts for TRICARE beneficiaries with autism

U.S. Sen. Thom Tillis (R-NC) joined a bipartisan call on Tuesday for the Department of Defense (DoD) to postpone benefit reductions for autism therapy.

The Defense Health Agency (DHA) has proposed cuts to reimbursement rates for Applied Behavior Benefits (ABA) therapy for TRICARE beneficiaries with Autism Spectrum Disorder.

The cuts, which are scheduled to take effect on March 30, would result in ABA services being restricted for more than 26,000 children of military personnel who have autism.

U.S. Sens. Kirsten Gillibrand (D-NY), Amy Klobuchar (D-MN) and Jerry Moran (R-KS) joined Tillis in a letter calling for Defense Secretary Ash Carter to immediately postpone the cuts.

“We ask that the proposed ABA reimbursement rate reductions prescribed by the DHA be immediately postponed pending careful re-evaluation of the existing research on reimbursement rates, and consideration of additional rigorous study, particularly with regard to reimbursements for paraprofessionals,” the senators wrote. “We urge that (Carter) take this action immediately before providers leave the TRICARE ABA services market and begin to no longer accept new TRICARE eligible ABA therapy patients. The children of our service men and women deserve nothing less.”

The senators noted that in addition to proposing ABA reimbursement rate cuts, DHA also imposed new certification requirements for behavior technicians (BT) who provide ABA services to TRICARE beneficiaries.

“While these certification requirements will ensure that TRICARE beneficiaries obtain ABA services from qualified technicians, they also impose additional costs on TRICARE ABA service providers,” the senators wrote. “Certification may extend as many as 130 additional days to the time it takes to hire, train and credential BTs to serve TRICARE beneficiaries. When considering that BTs are typically part-time employees with high turnover rates, these certification requirements will likely exacerbate the impact of reimbursement rate reductions.”

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