CHESAPEAKE, Va. — Military families are facing new difficulties in accessing therapy services, including in the realm of Applied Behavior Analysis (ABA) therapy, which some consider essential for individuals with special needs, particularly those with autism.
Some families go to a clinic for ABA services, while others welcome a therapist into their home on a daily or weekly basis.
Sarah Barr, a Chesapeake mother, expressed her distress over the potential loss of her 8-year-old son’s therapy due to insurance reasons.
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“We’re being told she can’t come because TRICARE won’t pay her,” she said. Barr went on to say, “To find out that he’s going to lose the last little bit that he receives is just – it’s unfair. It’s not fair. He’s just a child.”
Barr shared how her son was nonverbal until a few years ago and emphasized, “We rely on that hands-on and visual to help our children get through every day.”
When talking about his therapist, whom she described as a second mother to her son, she explained, “Last week, she told us that she was going to start cutting our services in half because she doesn’t want to abandon us. She’s a very important part of our lives. But as of February 3rd, if she hadn’t heard answers or known that things were even being processed, she would have to suspend the care. And that started on Monday,” Barr explained.
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Many companies attribute the disruptions to TRICARE’s transition to a new contractor for payment processing.
Elizabeth Matthews, owner and CEO of EMG Consulting, noted that she is currently paying her nearly 20 clinicians from reserves rather than from TRICARE funds.
“As of January 1st, we have not been paid for any services that we have provided,” Matthews stated.
Matthews, a military spouse and parent, conveyed her heartbreak over families at risk of losing vital services:
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“I regularly hear about different organizations that are leaving the TRICARE network because they don’t want to have to deal with situations like not getting paid,” she said.
Matthews said she reached out to lawmakers to advocate for families in need of therapy, and within the past day, she heard from a TRICARE representative who said they would be sending a check soon.
Brenda Campbell, a spokesperson for the Defense Health Agency TRICARE, wrote in a statement to News 3: “We are aware of some issues with claims in the TRICARE East region, and our managed care support contractor, Humana, is working diligently to resolve these.”
News 3 will update this story as more information becomes available.
