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BLS Certification Enforced for ABA Providers

12/22/2016

The extension for Applied Behavior Analysis (ABA) providers to get necessary certifications is ending. Effective January 1, 2017, claims submitted for services by providers who are not certified in Basic Life Support (BLS) or cardiopulmonary resuscitation (CPR) equivalent may be denied.

As part of TRICARE’s ongoing commitment to patient safety, the Defense Health Agency requires providers who deliver ABA services under the TRICARE Autism Care Demonstration (ACD) have BLS or CPR equivalent certification before they see TRICARE patients. Although many providers have complied with these requirements, there are still others who have not.

Some ABA providers in their local area have been identified by the TRICARE network contractor as not having met their BLS or CPR equivalent certification, or both, despite DHA's extra effort to provide them the opportunity and means to meet their obligations to patient safety.  Certification ensures these providers are consistently well-trained in ABA services. BLS or CPR equivalent training helps keep victims who may experience urgent or life-threatening events stable until they can get medical care from ambulance personnel or at a hospital. 

The DHA is very concerned that continued and uninterrupted care be provided to children receiving ABA services to the degree that we extended these deadlines to allow more than ample time for providers to meet these basic standards.  Providers who have chosen not to meet the requirements may no longer be able to provide therapy to TRICARE beneficiaries until they satisfy the minimum training and safety requirements. 

Autism care has been an emerging therapy and these requirements have been developed with your child’s safety in mind. If your child’s provider does not meet the standards, talk to your managed care support contractor or case manager to arrange a new provider who has complied.  You have a right to know if your child’s ABA provider is certified and has BLS or CPR equivalent certification. Talk to your child’s provider today.

Last Updated 12/27/2016