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T!STIMONYOF

JOHN O'BRIENDIRICTOR OF Ef,AITHCAXE AND INSURAiiCE

U.S. OFFICf, OT PERSOIYNEL MANACEMENT

b.fo.e the

UNITID STATf,S SENATE COMMIAIf,E ON ARMED SERI'ICESSIJB'OMMITTEE ON Pf, RSONNf, L

D.parhenl otDefebsetrograDr,trd Polici6ldSp{irl Nfrds

supDorr Milit.ry Frmilis Rilh

Chatnan Webb, RankinB Menber Gmham, and Membcrs ofthe Subsnmittee, lhrnk you lor

lhe opponuniry to make a natetoenr on b.hallof rhe Fedtral Employe.s Health Benefi! (FEHB)

PBeEn, adm in ht red by the US Ofiice of PeKonnel Manag.n.nt {OPM). We appreciale lhe

Subconin,itee\ inlercn in our progmm and ilssuppdn.ffamilies sho*children havc speial

nce'ls,specincallythose*ith Autisn Sp*lrum Disordes.

We undnsand rhe Subconmitee seeks in lodar ion ,boul our ftcenr cli$ificetiotrlfAPplied

B.haviorAnolysis (ABA) as medic.l thedpt In contunbthe single providermodel of

TRICARE,rheFEtlBprosramcontactsNilh9linsumncecmrisnboltrheahhplaisroovdS

nillior Federalemplolees, annuildb dndfimili.s. AllplansareRqunedloproidebasic

sevices,irdmrymgorirttoofferrrangeolad'litlonalbenefirs AllFIillBplans .requiEJ

io pro\idechild.en wirh auli.n acce$ to pedi?tri. care. phys calihe py, occtrplln n'lrhererl.

lFec h I r rapl. m enr.l h.ahh teatment. o nd n &l icar i.ns rloseve. id 2012, ABA is nornn

FEiIB benefir bccaus! i ncl&$ifed s sn inve$rg.nonalo' educarionalintelvenion lh(

lestinony olJohn O'Bri.nDirecto. olH.rllhc!E md Insur.reU.S. Ofiie ol PeMnd Mtntgeb.

deans rhar rhe child of a Fedeial enployee onnor aces ABA lhrough rheir h.ahh iNuranc.

rcglrdle$ of rvherher rhe plm \yould nomally consider nrch l@lmenl medioally nde$ary hd

pmvideillo its noi-Fedeml subscibeG.

Beginniq i. 2010, M.mbers ol Congfts, fanilies, and other s&t€holdd4 dked OPM to re-

examine this blaiketexclrion The OPM Benent Revie! Panel evalualcd tfie sbtus ofABA for

childEn Rilh dtism Previously, ABA {ar considered to b.an edrcationalinten€ntion and nor

coveFd u erthe fEHB PF8!om. TheBenefir Revies Panelo.cluded lhallhet is nos

sufficienl evide'ce ro crrego z.ABA as medicalrherapy. Accodingly, plansmaypbpdse

benefil pac*aces uhich i'rludeABA.

over lhe lan nvo )eaK, lhe infFstructurc to $plat rhe deh€r] ofABA has natuftd mpidly

Today 30 Srats require ar lea some healrh insurance evenge ofABA, Md 14 have liensure

pracedures lor ABA proidem ABA trcvide6 don freqtrendy have a gaduate deeree in

Psychology eith additional tmining inABA.leadinglo fomal Boani Cenifidrion inB€haviot

Analylis. Sldtes onen exercise thensl'pedision.lccniliedor licensd provideurhrou8h lhe

same path\ratuhhhovsneesolherhshh cee pmclilioneE, such as aBordolMedicineor

Psy. ho lo8ical Eraminds. lrisalsoconmonpGcticcbrequierphysicirn\orPsychologistk

prtsc.iprion belore i heahh plan rillapprove ABA lor a spsinc child.

OPM madc a decdioi lorelasifl AAA as a nedicalthempy drhst rhan an educationll seaice

based on rhc evolvin8 body oi clinical rescarch and the nrtuins pmvider infnsruqture to

delire, thismodell} uderamedicaln,odel. This rtcl.s ifr $rioD does D or pre$me 'ned

ical

ntresily rnd does nor sp{ificaLl) requne FEHB plans lo add AAA servicesrorhenbasic

benefib prckage Rdhcr, it allo*s lamiliesolFedemlemployee! to receive the samc neahent

.s lamiliesofnon teder. snlploye.s by.llo\rirg pla'sto p,opose All,4 as an addnionalbarent,

undq condiliotrs Nhcrc n,cdicol Nce$i! is satisfied and ippmpriare, qualifi ed prcvide^ arc

euilabk Medi.slrecesiry (eriaareeMn'ared by.achh.ilth phn inFEHB,no(byOPM

Planr a$es rldltr' a pnposen tedned s sata, nLpponed by somd medi.alcvi(efce,

efleurlve loi aD i',div dtral, n,ore etfecrive rl n alt{Ddirc t ahrer6,3trd cotrlorx 10 relevant

T6rinory ofJoh O,BrienDietorof Eqllh@Erndln nnc.U.S, Ofii.. ofP.nonr.l Mnm!.n€

Ju!.20.2012

slrnd&dsofnedicrlpncri@, Our d.cision.ppti6 onty ro FEHB, ond not io TRICAR!

poams, and dcordingly, wa puhlish€d 6 &ohnicd suid6€ to or cdi€d.

Th. .vide.€ i not ycl sufficie.t to supporl d oftisiil OIM pdsition rcauning co!.eSe by att

FEHB ddq' ln the int.aal, our adminisi*ive chrnF *itt lUow FEHS ptos d.t chose ro

do $ io nakc ABA seni6 alailable 6 tie E$arch dd pbvider b6e naluE. OpM wilpsiodi€lly re-Eview ABA ds rh. r.gch d.!.tops. We @ gnleirt for ah. Sub.ommi@tsuppdt orFedenl .oploy*s and then fanilies.

Th.nk )ru for liis opporu.iq, I a6 happy b rdd6 sny quoslions lhat you my hrve.