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TRICARE Management Activity Announcement:
Enhanced Access to Autism Services Demonstration

The TRICARE Management Activity (TMA) and its managed care support contractor (MCSC) partners continue to aggressively recruit providers for participation in the TRICARE's Enhanced Access to Autism Services Demonstration, which commenced in mid-March 2008. Because the demonstration is breaking ground by establishing a new class of autism treatment providers (paraprofessional tutors working under the direction of supervisors fully certified to provide applied behavior analysis), the initial phase has been devoted to recruiting providers in sufficient number to meet beneficiaries' demand for the demonstration's services. The rate at which providers have been brought into the demonstration has not met expectations.

TMA is committed to adjusting the demonstration's parameters as required to make it successful. To this end, we have already made changes by issuing modifications to the autism demonstration portion of the managed care contracts (e.g., increased provider reimbursement rates, eliminated some testing requirements for beneficiaries). A few of these modifications have been in the form of a "stop work" order to the MCSCs focused narrowly on specific provisions of the contracts. Some in the general public have misinterpreted this to mean TMA has stopped the demonstration itself. This is not the case. The demonstration remains underway, and services are being provided under it, though not yet in nearly the amount necessary to satisfy beneficiaries' needs. To rectify this, TMA will likely make further adjustments to the demonstration as more experience is gained in providing this new benefit.