TRICARE Appeals Take a Year Week of June 16, 2014 A report says that appealing a <http://www.military.com/benefits/tricare/your-tricare-benefits-explained.html> TRICARE decision can take as long as year. The report, which was sent to lawmakers on June 4 showed it takes an average of almost a year for TRICARE users who go through the entire appeals process to get a final ruling on whether the agency will pay for a non-emergency procedure or treatment which are ruled not medically necessary or against policy. According to the report, the 124 TRICARE users who appealed a coverage decision all the way to the final step -- a hearing -- between 2009 and 2013 received answers an average of about 346 days after their initial appeals. <http://www.military.com/daily-news/2014/06/13/report-tricare-appeals-taking-a-y ear.html> Read the full article on Military.com at http://www.military.com/daily-news/2014/06/13/report-tricare-appeals-taking-a-ye ar.html SOURCE: Military.Com Article at . http://www.military.com/military-report/tricare-appeals-take-year?ESRC=miltrep.n l Autism Care Demonstration Simplifies TRICARE ABA Benefits 6/16/2014 Starting this summer, a new Applied Behavior Analysis (ABA) policy will cover all TRICARE beneficiaries with autism spectrum disorder (ASD) under a single benefit. The Autism Care Demonstration (ACD) will start July 25, 2014 and will run until Dec. 31, 2018. All beneficiaries currently receiving ABA under TRICARE will transition seamlessly to the new benefit with no gap in coverage by Dec. 31, 2014. Currently, TRICARE beneficiaries with ASD get ABA covered by one of three programs, depending on their sponsor's duty status. The ACD combines these programs into a single benefit that will stay with beneficiaries if they move from active duty, retire or switch TRICARE plans. All ASD patients will have the same access to care, regardless of sponsor status or plan. TRICARE worked with military families, autism experts and advocacy groups to develop this policy and address concerns with previous TRICARE ABA policies. The ACD complies with the most recent Behavior Analyst Certification Board guidelines for ABA coverage. The ACD offers several enhancements to previous ABA TRICARE programs. There are no annual or lifetime caps on the amount of ABA TRICARE will cover, simpler guidelines for starting coverage once a child has an ASD diagnosis and consistent rules for what type of Board Certified Behavior Analysts (BCAB) can perform covered ABA. Further, the ACD's testing, authorization and review policies are simpler and offer parents and providers greater flexibility. The notice of the ACD was published in the Federal Register on June 16, 2014. TRICARE is still developing policy language to implement this program. For more information, and to subscribe to email updates on the ACD, visit <http://www.tricare.mil/aba> www.tricare.mil/aba. Last Updated 6/16/2014 SOURCE: TRICARE News Release, 16 June 2014, http://www.tricare.mil/CoveredServices/BenefitUpdates/Archives/06_16_14_AutismCa reDemo NOTICE: Links to archived copies of this and other mailing list messages, subscribe\unsubscribe instructions and other useful information for active duty, retirees and veterans, and their families, are available on the LINKS FOR MIL\RET\VETS website at www.hostmtb.org <http://www.hostmtb.org> If you prefer not to receive future RETVET-INFO mailing list messages, click here <mailto:health.mil-request@xxxxxxxxxxxxx?subject=Unsubscribe> to unsubscribe. If unsuccessful, please contact Mailing List Mgr <mailto:milton.bell126@xxxxxxxxx?subject=HEALTH.MIL%20Unsubscribe> .