[Federal Register Volume 75, Number 38 (Friday, February 26, 2010)]
[Notices]
[Pages 8927-8928]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2010-3990]


=======================================================================
-----------------------------------------------------------------------

DEPARTMENT OF DEFENSE

Office of the Secretary


Autism Services Demonstration Project for TRICARE Beneficiaries 
Under the Extended Care Health Option

AGENCY: Office of the Secretary, Department of Defense.

ACTION: Notice.

-----------------------------------------------------------------------

SUMMARY: This notice provides a 2-year extension of the Department of 
Defense Enhanced Access to Autism Services Demonstration Project under 
the Extended Care Health Option for beneficiaries diagnosed with an 
Autism Spectrum Disorder (ASD). Under the demonstration, the Department 
implemented a provider model that allows reimbursement for Intensive 
Behavioral Intervention (IBI) services, in particular, Applied Behavior 
Analysis, rendered by providers who are not otherwise eligible for 
reimbursement.

DATES: The demonstration will continue through March 14, 2012.

ADDRESSES: TRICARE Management Activity, Medical Benefits and 
Reimbursement Branch, 16401 East Centretech Parkway, Aurora, CO 80011-
9066.

FOR FURTHER INFORMATION CONTACT: Mr. Michael Kottyan, TRICARE 
Management Activity, Medical Benefits and Reimbursement Branch, 
telephone (303) 676-3520.

SUPPLEMENTARY INFORMATION: On December 4, 2007, the Department of

[[Page 8928]]

Defense published a Notice in the Federal Register (FR) (72 FR 68130) 
of a TRICARE demonstration to increase access to IBI services.
    The effective date was 60 days following publication of the Notice, 
and the demonstration was implemented on March 15, 2008 for a period of 
2 years. The purpose of the demonstration is to allow the Department to 
determine whether such a provider model increases access to services, 
the services are reaching those most likely to benefit from them, the 
quality of the services rendered meets the standard of care currently 
accepted by the community of providers, and whether State requirements 
for licensure or certification of providers of IBI services, where such 
exists, are being met. The Demonstration began enrolling beneficiaries 
and developing the network of providers of IBI services on March 15, 
2008. Subsequently, the Department determined that participation by 
both beneficiaries and providers was considerably less than expected 
due primarily to administrative requirements of the demonstration. In 
response, the Department developed and published revised operational 
guidance in September 2008. Although preliminary review indicates the 
demonstration can provide a measurable increase in access to IBI 
services, the need to modify our guidance contributed to a 6 month 
delay in evaluating the effectiveness of the demonstration. In 
addition, the Department recognizes that the subject of ASDs is 
complex, in particular, with respect to the number of individuals 
diagnosed with ASD, the treatment of ASD that generally includes 
several years of behavior modification through educational services, 
and the ability of the provider community to increase the number of 
qualified providers.
    Consequently, the Department has determined that continuation of 
the demonstration is both in the best interest of TRICARE beneficiaries 
diagnosed with an ASD, and necessary to collect sufficient 
comprehensive data, including the results of the recent survey of 
beneficiaries and providers participating in the demonstration, in 
order to fully evaluate the effectiveness of the delivery model 
employed by the demonstration. This extension will determine whether 
the demonstration met its stated purpose and provide the Department 
with the information necessary to make sound judgments regarding 
payment of benefits. The demonstration continues to be authorized by 10 
U.S.C. 1092.

    Dated: February 22, 2010.
Patricia Toppings,
OSD Federal Register Liaison Officer, Department of Defense.
[FR Doc. 2010-3990 Filed 2-25-10; 8:45 am]
BILLING CODE 5001-06-P