Independent Review Will Examine TRICARE’s Autism Coverage

Independent Review Will Examine TRICARE’s Autism Coverage
Children and family members march in support of autism awareness during an event at Marine Corps Base Camp Lejeune, N.C. (Photo by Lance Cpl. Andrea Ovalle/Marine Corps)

An independent evaluation will help set the course for TRICARE coverage of a key treatment for autism spectrum disorder … and it will rely heavily on input from military families.


The National Academies of Sciences, Engineering, and Medicine (NASEM) recently launched the evaluation of TRICARE’s Autism Care Demonstration (ACD), which stems from MOAA-supported language in the FY 2022 National Defense Authorization Act (NDAA). Military families are encouraged to submit feedback on their experiences, thoughts, and ideas about improving the treatment of autism and the measurement of effectiveness regarding applied behavior analysis (ABA) and the ACD.


The ACD has been underway for more than a decade, and MOAA believes an independent review is the best next step to determine appropriate TRICARE coverage policy for ABA.


[RELATED: What You Should Know About Updates to the Exceptional Family Member Program]


Congress directed the independent review shortly after TRICARE announced comprehensive changes to the ACD, including a policy clarification ending TRICARE coverage for behavioral technicians delivering ABA in school settings. Policy changes also established an Autism Services Navigator (ASN) for every new ACD participant, changes to outcome measures, and removal of the confirmation diagnosis requirement.


MOAA was pleased to see NASEM’s 15-member ad hoc committee of scientific/medical researchers, policy experts, clinicians, and advocacy groups includes two members of the military community: Jennifer Penhale, an active duty Air Force spouse who is the mother to three teenagers with autism and a longtime advocate for military families in the Exceptional Family Member Program; and Col. (Dr.) Eric Flake, USAF (Ret), who previously served as the pediatric consultant to the Air Force surgeon general and founded DoD’s Center for Autism Resource, Education, and Services at Joint Base Lewis-McChord, Wash.


Understanding the lived experience of individuals with autism and their family members, especially those who have been involved with TRICARE’s ACD, will be an essential component of the committee’s work, according to the NASEM website. Public information-gathering sessions will be held in conjunction with committee meetings, and listening sessions will also be held virtually in 2024.




Registration is open for the first public meeting, set for Nov. 15 at the National Academies Keck Center in Washington, D.C. The public session will include formal remarks from the sponsor (the Defense Health Agency), a question-and-answer session with the committee, and time for public comments. Livestream of the session will be available on the NASEM website.


MOAA urges military families with ACD experience to share this information with their networks and submit feedback to the committee via the online form.


MOAA is pleased to see robust efforts to gather feedback from military families with ACD experience. We will follow the committee’s progress throughout the evaluation period – the resulting report will be used to guide our future advocacy efforts on TRICARE’s ABA coverage and the ACD.



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About the Author

Karen Ruedisueli
Karen Ruedisueli

Ruedisueli is MOAA’s Director of Government Relations for Health Affairs and also serves as co-chair of The Military Coalition’s (TMC) Health Care Committee. She spent six years with the National Military Family Association, advocating for families of the uniformed services with a focus on health care and military caregivers.