A federal judge has ruled that Tricare must cover autism therapy for children of military retirees — but reimbursement for the treatment, called applied behavior analysis, could be years away while the issue remains tied up in the courts.

Judge Reggie Walton of U.S. District Court for the District of Columbia, ruled July 26 that Tricare’s coverage of ABA for family members of active-duty troops, but not family members of military retirees, is “arbitrary and capricious.”

Citing previous supporting cases, Walton sent the class-action suit back to Tricare “with instructions that ABA therapy coverage be provided to Tricare … beneficiaries who otherwise qualify for reimbursement.”

Under Tricare, ABA therapy is paid for under the Extended Health Care Option program, which is available only to active-duty personnel. Reimbursement for the intensive therapy, which teaches and reinforces behavior skills, stops when the active-duty Tricare sponsor retires.

Autism advocates are hailing the decision as a “big milestone” for military families.Click here to read more

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