To amend title 10, United States Code, to provide for the treatment of autism under TRICARE.

Revises TRICARE (a Department of Defense [DOD] managed health care program) to authorize treatment of autism spectrum disorders, if a health care professional determines that such treatment is medically necessary.

[Congressional Bills 111th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1600 Introduced in House (IH)]

111th CONGRESS
  1st Session
                                H. R. 1600

To amend title 10, United States Code, to provide for the treatment of 
                         autism under TRICARE.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             March 18, 2009

 Mr. Sestak (for himself, Mr. Rodriguez, and Mr. Jones) introduced the 
 following bill; which was referred to the Committee on Armed Services

_______________________________________________________________________

                                 A BILL


 
To amend title 10, United States Code, to provide for the treatment of 
                         autism under TRICARE.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. TREATMENT OF AUTISM UNDER TRICARE.

    (a) In General.--Section 1077 of title 10, United States Code, is 
amended--
            (1) in subsection (a), by adding at the end the following 
        new paragraph:
            ``(18) In accordance with subsection (g), treatment of 
        autism spectrum disorders.''; and
            (2) by adding at the end the following new subsection:
    ``(g)(1) For purposes of subsection (a)(18), treatment of autism 
spectrum disorders shall be provided if a health care professional 
determines that the treatment is medically necessary. Such treatment 
shall include the following:
            ``(A) Habilitative or rehabilitative care.
            ``(B) Pharmaceutical agents.
            ``(C) Psychiatric care.
            ``(D) Psychological care.
            ``(E) Speech therapy.
            ``(F) Occupational therapy.
            ``(G) Physical therapy.
            ``(H) Group therapy, if a health care professional 
        determines it necessary to develop, maintain, or restore the 
        skills of the beneficiary.
            ``(I) Any other care or treatment that a health care 
        professional determines medically necessary.
    ``(2) Beneficiaries under the age of five who have developmental 
delays and are considered at-risk for autism may not be denied access 
to treatment described by paragraph (1) if a health care professional 
determines that the treatment is medically necessary.
    ``(3) The Secretary may not consider the use of applied behavior 
analysis or other structured behavior programs under this section to be 
special education for purposes of section 1079(a)(9) of this title.
    ``(4) In carrying out this subsection, the Secretary shall ensure 
that--
            ``(A) a person who is authorized to provide applied 
        behavior analysis or other structured behavior programs is 
        licensed or certified by a State, the Behavior Analyst 
        Certification Board, or other accredited national certification 
        board; and
            ``(B) if applied behavior analysis or other structured 
        behavior program is provided by an employee or contractor of a 
        person authorized to provide such treatment, the employee or 
        contractor shall meet minimum qualifications, training, and 
        supervision requirements consistent with business best 
        practices in the field of behavior analysis and autism 
        services.
    ``(5) In this section:
            ``(A) The term `autism spectrum disorders' includes 
        autistic disorder, Asperger's syndrome, and any of the 
        pervasive developmental disorders as defined by the most recent 
        edition of the Diagnostic and Statistical Manual of Mental 
        Disorders.
            ``(B) The term `habilitative and rehabilitative care' 
        includes--
                    ``(i) professional counseling;
                    ``(ii) guidance service;
                    ``(iii) treatment programs, including not more than 
                40 hours per week of applied behavior analysis; and
                    ``(iv) other structured behavior programs that a 
                health care professional determines necessary to 
                develop, improve, maintain, or restore the functions of 
                the beneficiary.
            ``(C) The term `health care professional' has the meaning 
        given that term in section 1094(e)(2) of this title.''.
    (b) Regulations.--Not later than 180 days after the enactment of 
this Act, the Secretary of Defense shall prescribe such regulations as 
may be necessary to carry out section 1077(a)(18) of title 10, United 
States Code, as added by subsection (a).
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