Changes are coming to the military's healthcare program, Tricare . The changes will affect people who need Applied Behavior Analysis, a treatment for autism that is considered to be effective, according to people WAVY.com has interviewed.
ABA coverage under Tricare is changing, effective July 25. After that date, children with autism will need to take a standardized test every six months to show if the child is making progress. However, the child may no longer qualify for ABA if they don't take the test or if there's no progress.
"That's truly upsetting because the nature of ABA is that it grows with the child," said Laurie Stacey, a Behavior Consultant with Navigation Behavior Consulting. "So as the child progresses, you change what you're working on. I think Tricare's hoping because there's so many barriers in place that family members will just give up."
ABA therapy will be capped after two years unless the child or family has a special waiver. In order to receive more therapy, the parents will need to apply for the waiver.
The number of therapy hours a child gets per week could also be limited, and there is new discharge criteria, aside from the standardized testing progress.
A family could lose ABA coverage if the child doesn't show sustainable gains over time. ABA could also be lost if parents don't participate in the therapy.
The McNeills, a military family living in Hampton Roads, have a son who needs ABA. Jenny McNeill's seven-year-old son, Jacob, has autism. McNeill says the therapy has been life-changing for Jacob and many other children.
"Because he has made such great progress, we have seen what a great difference ABA makes," said McNeill. "We would just really hate to lose that for him and for other families."
Experts from Navigation Behavioral Consulting tell WAVY.com Tricare has not been forthcoming with information, which has been frustrating to affected families.
NBC is organizing a Call to Action in two locations against Tricare's new ABA policies this weekend. The events are happening Sunday, July 21. One demonstration is at 1535 Amberley Forest Road in Virginia Beach. The other location has not been determined. Click here to view the Facebook invite created for the event.
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