Health & Safety

January 31, 2014

Ask the Doc

doctor
Q.“Our sponsor is no longer on active duty. What do we need to do to get Applied Behavior Analysis for our child who may have an Autism Spectrum Disorder?”

A. “There are two parts to your question.
1. Under the basic TRICARE benefit, your child needs to have an Autism Spectrum Disorder diagnosed by a TRICARE-authorized primary care manager, provider or Autism Spectrum Disorder Specialist, who is either a physician board-certified or board-eligible in behavioral developmental pediatrics, neurodevelopmental pediatrics, pediatric neurology, child psychiatry or a Ph.D. clinical psychologist working primarily with children. The services under the basic benefit include:
• An initial assessment.
• Development of a treatment plan.
• One-on-one ABA interventions with an eligible beneficiary.
• Training of immediate family members to provide services in accordance with the treatment plan.
• The TRICARE basic benefit only covers delivery of ABA by a masters-level Board-Certified Behavior Analyst or doctoral-level Board Certified Behavior Analyst-Doctoral.
Individuals certified by the BACB as a Board Certified Assistant Behavior Analyst are not TRICARE authorized ABA providers under the TRICARE Basic Program.
2. Under the ABA Pilot, effective July 25, 2013, your child can receive additional ABA reinforcement services from either a bachelors-level Board Certified Assistant Behavior Analyst or a paraprofessional ABA Tutor under the supervision of a TRICARE authorized ABA provider licensed/certified by a State or by the Behavioral Analyst Certification Board as a BCBA. Requirements under the ABA Pilot include:
• Your child must be diagnosed with a qualifying ASD disorder by a TRICARE-authorized physician Primary Care Manager primary care provider or specialized ASD provider. Nurse Practitioners and Physician Assistants aren’t authorized ASD-diagnosing providers for ABA services under the ABA pilot.
• You child’s must have specific standardized psychometric tests done. The Autism Diagnostic Observation Schedule and Vineland Adaptive Behavioral Scale are required for your child to support ABA under the TRICARE basic benefit and ABA Pilot. The Vineland Schedule is required every six months for your child to continue reinforcement services under the ABA Pilot. You must be referred and get prior-authorization before receiving ABA initial and continuing ABA reinforcement under the Pilot.
Note:
On March 1, the CONUS Nurse Advice Line will provide 24 hour a day and 7 day a week nurse triage, advice and Military Treatment Facility appointing to the continental United States, Alaska and Hawaii. The NAL goals are to recapture care to the MTF, to reduce unnecessary Emergency Departments and Urgent Care utilization, to improve the patient’s continuous healthcare relationship with his or her MTF and PCM and to maximize patient satisfaction.
• MTF enrollees calling the NAL will gain immediate access to advice from registered nurses 24 hours a day and 7 days a week using standard triage protocols.
• NAL RNs will advise MTF enrollees on the most clinically appropriate level of care ranging from emergency to self-care.
• NAL will provide a parent or care-giver the option of a follow-up call if self-care is advised for any pediatric patients.
• NAL will inform PCM of any enrollee call to the NAL via a Telephone-Consult in Your electronic Health Record.”

TRICARE military benefits health plan service centers will end administrative walk-in services in the U.S. April 1. The closure of the TRICARE service center will not affect health care or TRICARE benefits. Customers may visit www.tricare.mil or call 1-877-988-9378 for TRICARE service.

Send your questions to askthedoc@nellis.af.mil.




All of this week's top headlines to your email every Friday.


 
 

 
U.S. Air Force photo by Senior Airman Thomas Spangler

40 years of Red Flag ends on high note

U.S. Air Force photo by Senior Airman Thomas Spangler A C-17 Globemaster III assigned to the 437th Airlift Wing, Charleston Air Force Base, S.C., flies to the Nevada Test and Training Range during Red Flag 15-4, Aug. 25. With a...
 
 

Never underestimate your impact

INCIRLIK AIR BASE, Turkey — Every day I visit our great Airmen and every day I come across more than one that underestimates their impact to the mission. There’s the one-stripe maintainer, “just repaneling an aircraft,” for the next day’s flight, or the young personalist, “just issuing another identification card,” or the defender, “just guarding...
 
 

Challenge yourself: Never give up, never quit

FAIRCHILD AIR FORCE BASE, Wash. — I once read that newly created cells in our bodies do one of two things: they either begin to decay or they become more vital. These cells choose their path based on what we demand of them. If we are sedentary, our brains signal our cells to decay; but...
 

 

SECDEF visits Nellis

U.S. Air Force photo by Lawrence Crespo U.S. Secretary of Defense Ash Carter speaks with Airmen from Nellis and Creech Air Force Bases during an all-call at the Lightning Aircraft Maintenance Unit hangar on Nellis AFB, Nev., Aug. 26. Carter’s department is responsible for policy development, planning, resource management, fiscal, and program evaluations for the...
 
 

Air Force extends SAPR services to AF civilians

WASHINGTON — The Air Force released a policy memo today allowing Air Force civilian employees who are victims of sexual assault to file restricted and unrestricted reports with their installation’s sexual assault response coordinator. The policy is effective immediately and allows SARCs and sexual assault prevention and response victim advocates to assist Air Force civilians...
 
 

TRICARE pharmacy rules changing for maintenance, brand-name drugs

WASHINGTON — TRICARE beneficiaries who take certain brand-name medications on a regular basis will be required to fill prescriptions at a military treatment facility or through a mail-in program beginning Oct. 1, a Defense Health Agency official said here Aug. 20. George Jones, DHA’s pharmacy operations division chief, said the new policy does not apply...
 




0 Comments


Be the first to comment!


Leave a Reply

Your email address will not be published. Required fields are marked *

You may use these HTML tags and attributes: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <s> <strike> <strong>