MARADMINS : 583/14
R 062223Z NOV 14
MARADMIN 583/14
MSGID/GENADMIN/CMC WASHINGTON DC MRA MF//
SUBJ/DEPARTMENT OF DEFENSE (DOD) COMPREHENSIVE AUTISM CARE DEMONSTRATION//
REF/A/MSGID:DOC/TRICARE OPERATIONS MANUAL 6010.56-M, CHAPTER 18, SECTION 18/20140919//
AMPN/REF A IS TRICARE POLICY ESTABLISHING A COMPREHENSIVE AUTISM CARE DEMONSTRATION//
POC/J. STEWART/CIV/UNIT:MFY-1/-/TEL:703-784-0298//
GENTEXT/REMARKS/1. BACKGROUND. THE COMPREHENSIVE AUTISM CARE DEMONSTRATION COMBINES ALL TRICARE-COVERED APPLIED BEHAVIOR ANALYSIS (ABA) SERVICES UNDER ONE DEMONSTRATION AND PROVIDES TRICARE REIMBURSEMENT FOR ABA AND RELATED SERVICES TO TRICARE ELIGIBLE BENEFICIARIES DIAGNOSED WITH AUTISM SPECTRUM DISORDER. THIS DEMONSTRATION INCORPORATES ABA SERVICES THAT WERE PROVIDED UNDER THE TRICARE BASIC PROGRAM, THE ENHANCED ACCESS TO AUTISM SERVICES DEMONSTRATION, AND THE ABA PILOT.
2. REQUIREMENTS FOR COVERAGE UNDER THE AUTISM CARE DEMONSTRATION ARE EFFECTIVE AS OF 25 JULY 2014, THE STATUTORY END DATE OF THE CURRENT ABA PILOT, WITH ALL BENEFICIARIES TRANSITIONED FROM THEIR CURRENT ABA COVERAGE MODEL TO THE NEW AUTISM CARE DEMONSTRATION NO LATER THAN 31 DECEMBER 2014.
3. FAMILIES ARE ENCOURAGED TO CONTACT THEIR REGIONAL OR PLAN CONTRACTOR FOR SPECIFIC DETAILS AND INFORMATION ABOUT TRANSITIONING TO THE NEW DEMONSTRATION. TRICARE NORTH REGION BENEFICIARIES MAY CONTACT HEALTH NET FEDERAL SERVICES, LLC AT WWW.HNFS.COM OR 1-877-874-2273. TRICARE SOUTH BENEFICIARIES MAY CONTACT HUMANA MILITARY AT HUMANA-MILITARY.COM OR 1-800-444-5445. TRICARE WEST BENEFICIARIES MAY CONTACT UNITEDHEALTHCARE MILITARY AND VETERANS AT WWW.UHCMILITARYWEST.COM OR 1-877-988-9378. OVERSEAS BENEFICIARIES MAY CONTACT INTERNATIONAL SOS, GOVERNMENT SERVICES, INC. AT WWW.TRICARE-OVERSEAS.COM. COUNTRY SPECIFIC PHONE NUMBERS CAN BE FOUND ON THE TRICARE WEBSITE. BENEFICIARIES USING TRICARE FOR LIFE OR U.S. FAMILY HEALTH PLAN SHOULD VISIT WWW.TRICARE.MIL FOR THEIR POINT OF CONTACT.
4. FOR ADDITIONAL INFORMATION ON THE AUTISM CARE DEMONSTRATION, OR SPECIFIC QUESTIONS SPONSORS AND FAMILY MEMBERS MAY VISIT HTTP: (SLASH)(SLASH) TRICARE.MIL(SLASH)PLANS(SLASH)SPECIALPROGRAMS2 (SLASH)AUTISM(SLASH)ACD.ASPX?SC_DATABASE=WEB. BENEFIT UPDATES ARE AVAILABLE BY E-MAIL ALERTS; SIGN UP AT WWW.TRICARE.MIL(SLASH) SUBSCRIPTIONS.
5. RELEASE AUTHORIZED BY BGEN R. A. C. SANBORN, DIRECTOR, MARINE AND FAMILY PROGRAMS DIVISION.//