|
 |
TRICARE is offering a new benefit called the "Autism Demonstration Project" for beneficiaries who qualify. As the contractor for TRICARE in the SOUTH, HMHS would like to ensure our providers are informed and understand this new benefit feature. Included is a description of the service, how our Primary Care Managers are important to directing care for this new service, and the requirements for the providers qualifying to perform the services.
|
|
Dear Provider:
It is estimated that approximately 8,500 children of active duty service members carry one of the Autism Spectrum Disorder (ASD) diagnoses. With that as the focus and inspiration, the Department of Defense is introducing The Enhanced Access to Autism Services Demonstration Project (Demonstration).
This special Demonstration project is designed to improve access to special education services for eligible children with Autism Spectrum Disorder (ASD). It does this by permitting reimbursement of services delivered by non-certified, but intensively supervised Educational Interventions for Autism Spectrum Disorders (EIA) Tutors and Tutors-in-Training.
To participate in this Demonstration you must be a TRICARE-authorized provider as either an Individual Corporate Services Provider (ICSP) or an Organizational Corporate Services Provider (OCSP).
Within the CSP structure, an Educational Interventions for Autism Spectrum Disorders (EIA) Supervisor, who meets the education and certification requirements, may provide supervisory oversight to EIA Tutors, Tutors-in-Training and other EIA Supervisors in the delivery of EIA services to TRICARE beneficiaries.
Reimbursement for EIA services delivered by EIA Supervisors, EIA Tutors and Tutors-in-Training is established by TMA and is outlined in the TRICARE Operations Manual, Chapter 20, Section 10, 9.0 -Administration. Reimbursement is based upon the locality-based CHAMPUS Maximum Allowable Charge.
We are committed to serving our beneficiaries and value your contribution to the treatment of individuals with an ASD diagnosis. We will do everything possible to assist you in becoming a TRICARE-authorized CSP. Please see the related materials for additional information.
|
