Federal Court Rules against DoD on ECHO Benefits
8/6/2012
A recent Federal Court decision ruled that TRICARE Basic benefits should be expanded to include Applied Behavioral Analysis (ABA) for the treatment of Autism Spectrum Disorder for all beneficiaries.
TriWest Healthcare Alliance (TriWest) must receive direction from the TRICARE Management Activity (TMA) specifying any changes to benefits. To date, TriWest has not received specific direction from TMA regarding the provision of ABA therapy under the TRICARE Basic Program.
Until other direction is received from TMA, ABA therapy is currently only reimbursable under TRICARE ECHO Basic or the ECHO Autism Demonstration and subject to program eligibility and requirements.
Updates will be provided, when available, via the TRICARE eNews and at TriWest.com/Provider.