Today, the U.S. House of Representatives passed the National Defense Authorization Act (NDAA), the $691 billion bill that directs critical U.S defense policy for 2017. Secured inside the bill is a targeted and critical amendment co-authored by U.S. Rep. Chris Smith (NJ-04) which will ensure military families with a child on the autism spectrum will continue to have access to a key intervention therapy. The Smith provision protects coverage of and access to Applied Behavior Analysis (ABA) therapy—an evidence-based behavior intervention that is widely accepted among health care professionals as an effective therapy for Autism Spectrum Disorder (ASD).
“Military life is defined by frequent changes of residence and schools, and prolonged absences of a parent, which can be particularly difficult for children with autism,” said Smith, founder and co-Chair of the House Autism Caucus. “ABA therapy is a proven and effective intervention that brings about positive behavior change that can assist military children in coping with the unique challenges of military life, while also demonstrating positive long-term results.”
In July 2014, TRICARE began the Comprehensive Autism Care Demonstration, an initiative to cover ABA for TRICARE beneficiaries diagnosed with ASD. The demonstration, scheduled to end in December 2018, was initiated in order to expand access to coverage for beneficiaries.
Late last year, however, TRICARE proposed a reduction in reimbursement rates for ABA, which may reduce the access military dependents have to ABA practitioners. As a response, in March 2016 Smith led a bipartisan effort of 40 Members of Congress and endorsed by a coalition of autism and military families advocacy organizations—Including the National Military Family Association (NMFA), Military Special Needs Network, the TRICARE for Kids Stakeholders Coalition, and Autism Speaks—in urging the Department of Defense (DOD) to halt the proposed reimbursement rate reductions. Ultimately however, in April 2016, TRICARE enacted the first round of reduced reimbursement rates for coverage. Particularly concerning is the effect the proposed reductions—of as much as 15 percent annually in reimbursement rates for ABA services—will have on communities where access is already limited.
The amendment is included in the NDAA—which is expected to pass the Senate next week with the amendment intact—and will ensure that the reimbursement rates are not below their pre-April level through the remainder of the Demonstration project: “during the period beginning on the date of the enactment of this Act and ending on December 31, 2018, the Secretary of Defense shall ensure that the reimbursement rates for providers of applied behavior analysis are not less than the rates that were in effect on March 31, 2016.”
“ABA therapy improves a variety of skills by encouraging positive behaviors and discouraging negative behaviors and the NDAA will ensure the more than 26,000 military children with ASD do not lose access to these critical services,” Smith concluded.
Smith is the author of three laws designed to expand research into Autism, the most recent being the “Autism Collaboration, Accountability, Research, Education, and Support Act of 2014.” He has also chaired two hearings on Autism around the world, including “The Global Challenge of Autism” in 2014. The importance of Autism research was brought to his attention in 1997 when Bobbie and Billy Gallagher, parents of two autistic children, expressed their concerns to him about a possible autism cluster in Brick, N.J..
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