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Autism Care Demonstration

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A new TRICARE West Region contract is scheduled to start Jan. 1, 2025. With this, the West Region contractor will change from Health Net Federal Services, LLC (HNFS) to TriWest Healthcare Alliance (TriWest). HNFS is honored to provide exceptional service under the current West Region contract, and we will continue to do so throughout the remainder of our contract.

Read our West Region transition FAQs to learn more. 

HNFS and our team of clinicians and coordinators will continue to assist you with your health care through Dec. 31, 2024. HNFS and TriWest are working together to ensure a smooth transition. We have provided TriWest with all the information needed to manage your care under the Autism Care Demonstration (ACD). 

This transfer of data includes referral and authorization details, supporting clinical documents, completed outcome measures (Vineland, SRS, SIPA, PSI, PDDBI), ACD eligibility documents (validated assessment tools), documents related to the authorization process (DSM V Checklists, treatment plans), and other applicable data elements, including due dates for referrals and the ACD program requirements. 

For those who currently have an assigned Autism Service Navigator (ASN), we have provided TriWest all Comprehensive Care Plans and their corresponding due dates. Your newly assigned ASN at TriWest will be reaching out to you. Should you have questions about your ASN assignment, please contact TriWest directly on or after Jan. 1, 2025.

We know that continuity of care is critical to effective applied behavior analysis service. You can now view TriWest’s network directory at www.tricare.mil/west to check if your providers are currently in TriWest’s network (providers are added daily). 

Questions about ACD referrals and authorizations after Jan. 1? Read the related article in the TRICARE Newsroom

Overview

Welcome! Through the Autism Care Demonstration (ACD), TRICARE-eligible beneficiaries diagnosed with autism spectrum disorder (ASD) have access to applied behavior analysis (ABA) and care coordination services. 

TRICARE offers multiple services to support beneficiaries diagnosed with ASD. Visit www.tricare.mil/autism for details. 

Looking for providers? Search our ACD-specific directory:

 

 

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Who's Eligible?
TRICARE beneficiaries must meet specific qualifications.
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Autism Care Demonstration Participation
Learn about diagnostic and eligibility criteria requirements for ACD enrollment.
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Referrals
Referrals for ABA services are valid for two years.
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Initial Assessments
Overview of the initial assessment process.
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Outcome Measures
Scores are used in treatment planning and evaluating progress over time.
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Initial Treatment Authorization
Approvals are six months in length and in place prior to service delivery.
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Clinical Necessity Reviews
All treatment plans are reviewed and must meet requirements before treatment is authorized.
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Service Settings
ABA services may be rendered in a variety of settings.
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Receiving ABA Services
Learn about access to care, parent training and changing providers.
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Copayments & Cost Shares
Access information related to TRICARE costs.
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Subsequent Treatment Authorizations
Explore the requirements for ongoing care beyond initial referral and authorization.
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Discharge Planning
What to expect when preparing to exit the ACD.
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Moving? 
The streamlined transfer process helps eliminate gaps in service.
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File a Complaint
Unresolved issue or concern? Contact HNFS' Complaint Officer.