II 

111TH CONGRESS 

1ST SESSION S. 1169 

To amend title 10, United States Code, to provide for the treatment of 

autism under TRICARE. 

IN THE SENATE OF THE UNITED STATES 

JUNE 3, 2009 

Mrs. GILLIBRAND (for herself, Ms. COLLINS, Mr. CARDIN, Mr. SANDERS, Mr. 

BROWNBACK, and Mr. SPECTER) introduced the following bill; which was 

read twice and 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. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. TREATMENT OF AUTISM UNDER TRICARE. 

4 (a) IN GENERAL.—Section 1077 of title 10, United 

5 States Code, is amended— 

6 (1) in subsection (a), by adding at the end the 

7 following new paragraph: 

8 ‘‘(18) In accordance with subsection (g), treat9 ment of autism spectrum disorders.’’; and 


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1 (2) by adding at the end the following new sub2 section: 

3 ‘‘(g)(1) For purposes of subsection (a)(18), treatment 

4 of autism spectrum disorders shall be provided if a health 

5 care professional determines that the treatment is medi6 cally necessary. Such treatment shall include the following: 

7 ‘‘(A) Habilitative or rehabilitative care. 

8 ‘‘(B) Pharmaceutical agents. 

9 ‘‘(C) Psychiatric care. 

10 ‘‘(D) Psychological care. 

11 ‘‘(E) Speech therapy. 

12 ‘‘(F) Occupational therapy. 

13 ‘‘(G) Physical therapy. 

14 ‘‘(H) Group therapy, if a health care profes15 sional determines it necessary to develop, maintain, 

16 or restore the skills of the beneficiary. 

17 ‘‘(I) Any other care or treatment that a health 

18 care professional determines medically necessary. 

19 ‘‘(2) Beneficiaries under the age of five who have de20 velopmental delays and are considered at-risk for autism 

21 may not be denied access to treatment described by para22 graph (1) if a health care professional determines that the 

23 treatment is medically necessary. 

24 ‘‘(3) The Secretary may not consider the use of ap25 plied behavior analysis or other structured behavior proVerDate Nov 24 2008 02:16 Jun 04, 2009 Jkt 079200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S1169.IS S1169

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1 grams under this section to be special education for pur2 poses of section 1079(a)(9) of this title. 

3 ‘‘(4) In carrying out this subsection, the Secretary 

4 shall ensure that— 

5 ‘‘(A) a person who is authorized to provide ap6 plied behavior analysis or other structured behavior 

7 programs is licensed or certified by a State, the Be8 havior Analyst Certification Board, or other accred9 ited national certification board; and 

10 ‘‘(B) if applied behavior analysis or other struc11 tured behavior program is provided by an employee 

12 or contractor of a person authorized to provide such 

13 treatment, the employee or contractor shall meet 

14 minimum qualifications, training, and supervision 

15 requirements consistent with business best practices 

16 in the field of behavior analysis and autism services. 

17 ‘‘(5) In this section: 

18 ‘‘(A) The term ‘autism spectrum disorders’ in19 cludes autistic disorder, Asperger’s syndrome, and 

20 any of the pervasive developmental disorders as de21 fined by the most recent edition of the Diagnostic 

22 and Statistical Manual of Mental Disorders. 

23 ‘‘(B) The term ‘habilitative and rehabilitative 

24 care’ includes— 

25 ‘‘(i) professional counseling; 


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1 ‘‘(ii) guidance service; 

2 ‘‘(iii) treatment programs, including not 

3 more than 40 hours per week of applied behav4 ior analysis; and 

5 ‘‘(iv) other structured behavior programs 

6 that a health care professional determines nec7 essary to develop, improve, maintain, or restore 

8 the functions of the beneficiary. 

9 ‘‘(C) The term ‘health care professional’ has the 

10 meaning given that term in section 1094(e)(2) of 

11 this title.’’. 

12 (b) REGULATIONS.—Not later than 180 days after 

13 the enactment of this Act, the Secretary of Defense shall 

14 prescribe such regulations as may be necessary to carry 

15 out section 1077(a)(18) of title 10, United States Code, 

16 as added by subsection (a). 

Æ 


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