Submitted by: Beth Vaughan

Our very own Jamie Redding (Senior Vice President) and Missy Rolison (Vice President of Operations) for Reaching Milestones recently took a trip to Washington, DC last week to meet with members of the United States Congress. The mission of the trip was an extremely important one for all of us involved in both the Autism and Military communities.

Recently, it has become difficult for many military families to find in-network specialists for their children who have been diagnosed with Autism. According to a group of US Senators, this is in part, due to the way federal officials have changed health insurance plan reimbursements earlier this year. A group of six lawmaking senators (including North Carolina’s Thom Tillis) are calling for Congress to reverse the reimbursement cuts via additional funding and sent a letter to federal funding decision makers last week, asking for this very serious issue to be addressed. The letter asks for leaders on the House and Senate appropriations committees to include $32 million in upcoming budget legislation. That money is expected to effectively reverse the reimbursement rate cuts and address the shortage of ABA therapy providers.

According to the Senators, the reimbursement issue arose after Defense Health Agency officials changed the rate that TRICARE pays medical providers (such as Reaching Milestones) for Applied Behavior Analysis therapy. Through TRICARE, military beneficiaries diagnosed with ASD are eligible to receive ABA treatment. The Academy of Pediatrics fully supports and endorses ABA as an effective treatment for individuals with Autism. A Report of the Surgeon General states, “Thirty years of research demonstrated the efficacy of applied behavioral methods in reducing inappropriate behavior and in increasing communication, learning, and appropriate social behavior. The ABA treatment program is used by nearly half of the 26,000 children covered by TRICARE who have been diagnosed with Autism.

On April 1, 2016, the DHA imposed reimbursement rate cuts of as much as 15% for ABA services in most areas of the country. These cuts were imposed despite indications from military families from across the country that they were experiencing ABA provider shortages; and, in some locations, families had no access to providers at all. Just this week, 3 providers in San Diego were forced to shut their doors and a major ABA provider in the Georgia area had to close down all but one of their locations because they could not afford to stay open.

The House and Senate has already approved the National Defense Authorization Act for fiscal year 2017 to include reinstating ABA reimbursement rates. However, that bill does not appropriate federal funding for such costs and final approval of the budget is expected later this year (most likely December).

Missy and Jamie personally met with 10 members of the US Senate and were very enthused by the conversations that took place. They were able to lock in signatures from these representatives and came back to Jacksonville feeling very positive about the potential outcome.

This mission is far from over, and the efforts to reverse the rates don’t stop with the Jamie, Missy and the group of Senators. We need YOUR help! Sign the petition. Voice your opinions and concerns. Let TRICARE and Congress know how important ABA is for the future of your children. Progress is made every single day with ABA. Please contact your local congressman and senators to voice your opinion and let them know how important this is to all of us!

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Autism is a developmental brain disorder that affects normal brain functions. This neurological condition affects a person’s reasoning, social skills and communication skills. The condition becomes apparent during the first 3 years of a child’s life. Because areas of the brain have difficulties working together, children with autism will have challenges in relating and communicating with others. Those afflicted with the disorder may still be able to reach their full potential with an early diagnosis and effective treatment.

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