Autism Care Demonstration
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 with 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 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 beneficiaries who currently have an assigned Autism Service Navigator (ASN), we have provided TriWest all Comprehensive Care Plans and their corresponding due dates. The newly assigned ASN at TriWest will be reaching out. Beneficiaries who have questions about their ASN assignment should 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 you are currently listed in TriWest’s network (providers are added daily).
Questions about ACD referrals and authorizations after Jan. 1? Read the related article in our Newsroom.
Overview
TRICARE’s Autism Care Demonstration (ACD) allows for clinically necessary and appropriate applied behavior analysis (ABA) services to be rendered to TRICARE-eligible beneficiaries diagnosed with autism spectrum disorder (ASD). Please refer to TRICARE Operations Manual, Chapter 18, Section 4 for complete policy details.
To learn more, find past Defense Health Agency (DHA)-led presentations, and to sign up for email updates, visit www.health.mil/autism.
Looking for providers? Search our ACD-specific directory:
Outcome Measures
Scores are used in treatment planning and evaluating progress over time.
Clinical Necessity Reviews
Health Net Federal Services, LLC (HNFS) performs clinical necessity reviews on all treatment authorization requests.
Exclusions
Services excluded from the ACD are not reimbursable and will not be authorized.
Annual Provider Training
All autism corporate services providers (ACSPs) and ABA sole providers participating in the ACD are required to complete annual training.
Contact Us
Questions? HNFS' ACD team is standing by to assist.