UPDATE: Paul Heads to the Pentagon… AGAIN!


By: Beth Vaughan
On July 28th, Paul and Missy headed back to D.C. for the second Tricare Autism Care Demonstration Roundtable Discussion with other stakeholders. Prior to the meeting, the invited attendees were allowed to submit questions to the board, with the intent to be answered/discussed during the Roundtable.

Paul and Missy explained that their primary interest relates to increasing the accessibility of high quality ABA services. They also expressed that they have serious concerns about the lengthy process of credentialing Registered Behavior Technicians (RBTs). This process is becoming a significant barrier for military families attempting to access ABA services. There needs to be better and more access to quality care. If Tricare only credentials BACB (Behavior Analyst Certification Board) certified RBT’s, families will be forced to wait weeks, or even months, to begin receiving services. And, we at Reaching Milestones know first-hand how much progress can be made within a child, in that amount of time!

During the Roundtable Discussion, Paul made the recommendation for Tricare to credential Behavior Technicians with a 90-day probationary period. During this period, the BT would need to complete the process for becoming a certified RBT. This would allow newly hired Behavior Technicians to begin working on their certification task list and avoid creating a barrier to service accessibility. He also expressed his concern on the maximum 20% Supervision rule for Tricare kids. It is our belief that each child is unique, and therefore each child has different needs when it comes to ABA treatment. The people implementing these standardized supervision rules are not BCBA’s, or behavior professionals, and some clients require more than 20% of supervised time while in therapy.

The meeting was beneficial for those in attendance, as well as military families. There has been a change to the Beneficiary Cost Share process – which is a huge success! In the past, retiree families could only see a BCBA. There is now more flexibility with whom the client can see; the ACD now supports a team approach to ABA and allows for consultation with, or assistant by, other BCBA’s. This creates more access to services and creates more freedom for families and scheduling of therapy. They also announced that all ABA services, including the tiered model services, will accrue towards the catastrophic cap, effective 10/1/2015. There will no longer be a 10% cost-share for tiered services for non-active duty family members. All cost-sharing will follow the Tricare plan military families currently have and will apply to the catastrophic cap.

The stakeholders were impressed with Paul’s knowledge and have asked him to participate in a Focus Group that has been created to streamline/simplify the credentialing process. This group would focus on bridging the gap between providers becoming credentialed and beneficiaries receiving access to services.
The next Roundtable Discussion will be in the next 90-120 days and the same group in attendance on 7/28 will be invited back. The hope is that a decision will be made on the rates by then, although, the changes would not go into effect until March/April of 2016.

For more information and FAQ’s, please visit: http://www.health.mil/Frequently-Asked-Questions/Autism-Care-Demonstration