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Pentagon to cut autism healthcare payments in half

Pentagon to cut autism healthcare payments in half
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Military families are concerned they could lose medical help for their autistic children because of planned spending cuts at the Pentagon.

As part of an effort to reduce its healthcare costs, the Pentagon is planning to slash payments in half to providers who work with autistic children under TRICARE, the military’s healthcare plan.

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The latest TRICARE manual, released in September, cuts their pay from $125 a hour to between $50 and $68 an hour.

Many healthcare providers are balking at the pay cuts, saying they won’t be able to provide the services without the additional money. If they go through, providers say the services will disappear.

That’s sparked a panic among families that use the programs and their advocates.

“These new changes to autism therapy could be game over for some of our military families around the country,” said Amanda Kelly, a board certified behavior analyst who works with autistic children for Keiki Educational Consultants. 

A new survey of TRICARE providers who work with autistic children finds 95 percent of these providers plan to cut back on the services they offer, while 22 percent intend to stop working with military children altogether.

The study was conducted by Navigation Behavioral Consulting, a healthcare provider that works with autistic children.

“What will families do?” asked Kate Disney, the mother of a child with autism who is afraid her family will lose TRICARE coverage under the changes.

The changes, announced in the Federal Register in June, are scheduled to take effect on Oct. 20.

According to TRICARE documents, more than 7,800 military children received autism benefits in 2013. 

The Pentagon says it is trying to simplify the autism program and insists these families will continue to have access to autism treatment under the new program.

“Beneficiaries currently receiving (coverage) under an existing TRICARE policy will seamlessly transition to the Autism Care Demo with no gap in coverage and no increase in cost — there will be no changes to their current plan,” said Maj. Gen. Richard W. Thomas, director of health operations for the Defense Health Agency, in a statement to The Hill. 

Healthcare providers, however, say that they have been shut out from the process and received little to no communication from TRICARE about how the changes will affect the autistic children they serve.

They are worried that even if military families do not lose their TRICARE coverage under the changes, they may have problems with finding available healthcare providers to work with their autistic children.

If providers cut back on their services due to the pay cuts, it will create a shortage of providers that could leave more than 1,100 autistic children without help, according to the survey from Navigation Behavioral Consulting.

Meanwhile, the remaining healthcare providers that continue working with autistic children say they would face new limitations in what skills they can teach them.

“Even for those kids who are still getting services, they’re greatly limiting what we’re able to do with those children,” said Megan Miller, a board certified behavior analyst with Navigation Behavioral Consulting.

Previously, healthcare providers taught autistic children communication, social, behavioral, developmental, cognitive, mental health, motor, adaptive, academic and vocational skills, Miller said. But under the new rules, she said they will only be allowed to teach communication, social and behavior skills, restricting how much the autistic children can learn and grow.

“I am very concerned regarding the restricted focus of services,” said Mandy Farmer, whose son receives autism coverage from TRICARE. “My son is three years old and we are in the thick of it with potty training and focus.

“I just can’t believe they are making these decisions about treatment without consulting (health care professionals) on how this will affect our children,” she added.

An official from the Department of Defense explained all of these skills will still be covered, but they are being merged together in three broader categories.