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Cole Leads Introduction of the TRICARE ECHO Improvement Act

March 9, 2020
Press Release

Washington, D.C. – Today, Congressman Tom Cole (OK-04) and Congresswoman Elaine Luria (VA-02) introduced the bipartisan TRICARE ECHO Improvement Act, which would make commonsense changes to TRICARE’s existing Extended Care Health Option (ECHO) program.

While Congress created TRICARE’s ECHO program for families of active-duty service members to serve as an alternative to Medicaid’s Home and Community-Based Services (HCBS) waiver programs, it currently fails to provide comparable services. Since Medicaid is a program based on state residency, military families often face HCBS waiver access challenges due to frequent moves required by their military service. To fix this problem, the legislation outlines a more robust ECHO program that improves access for military families with special needs dependents and that provides equitable coverage of the services widely offered to residents of many states through Medicaid. 

“Perhaps the most selfless Americans in our communities are those who answered the call to serve and defend our nation in the military, along with their families who support them and make daily sacrifices of their own. Certainly, these selfless individuals and families deserve the very best and most consistent care we can give them,” said Congressman Tom Cole. “Since military service can mean frequent moves, we must ensure the same quality of health care and services is maintained and not disrupted due to a change in their location. To provide that much-needed consistency for our military families, I am proud to introduce the TRICARE ECHO Improvement Act.”

“Military families sacrifice for our nation. We owe them equitable access to critical health care services,” said Congresswoman Elaine Luria. “Many servicemembers and their families are unable to access state residency-based benefits like the Medicaid Home and Community-Based Services waivers because the nature of their service requires them to move frequently. I’m honored to work alongside Representative Cole to expand health care access to these families and to fill the coverage gaps that they experience.”

“When a child is sick, getting the care they need is the primary mission of any family,” said Kara Oakley, Chair of the Tricare for Kids Coalition. “But unfortunately, frequent moves and long state waitlists delay needed Medicaid services for many medically complex children in our nation’s military families. Improving benefits offered under ECHO is one step towards giving military kids the care they need and giving military parents peace of mind.”

“Children’s hospitals are here to advocate all kids getting the same level of care – the best we can provide – so they can develop and thrive,” said Mark Wietecha, President and CEO of the Children’s Hospital Association. “We work with all children’s health care programs from Medicaid to TRICARE to provide the unique services children need. We’re proud to support this legislation to ensure the children of our nation’s brave military families have access to the same level of services as other children.”

“MOAA is pleased to support the TRICARE ECHO Improvement Act. This important legislation fixes coverage gaps in TRICARE’s Extended Care Health Option, a critical resource for special needs military families who are unable to access State Medicaid Waiver programs,” said Lieutenant General Dana Atkins, President and CEO of the Military Officers Association of America (MOAA). “Increased ECHO respite hours and other coverage enhancements will greatly assist families who face many challenges navigating military life while also caring for their special needs family members. We thank Rep. Cole and Rep. Luria for introducing this bill that has the potential to help so many special needs military families.”

“ECHO has failed to provide the necessary level of support for military children enrolled in the program. While TRICARE established ECHO as a substitute for state Medicaid Waiver services that are often unavailable to mobile military families, it has fallen short, especially in terms of respite care,” said Ashish S. Vazirani, Executive Director and CEO of the National Military Family Association. “This legislation will make significant improvements in the level of services provided to military children and their families.”

Improvements to the TRICARE ECHO Program outlined by the legislation:

  • Increases hours of covered respite care. Respite care is short-term care for a patient to provide rest for the patient’s primary caregiver. ECHO currently covers only 16 hours per month while states, on average, cover 60 hours. The TRICARE ECHO Improvement Act would increase ECHO coverage to 50 hours monthly. 
  • Codifies new regulations on respite care eligibility. Under recently revised regulations, respite care may be offered regardless of whether the eligible dependent receives another ECHO benefit. The TRICARE ECHO Improvement Act would codify this policy change. 
  • Codifies existing coverage of durable equipment. Under current regulations, ECHO may cover service and modification of durable equipment and assistive technology devices, as well as training in use, to ensure equipment is fully functional and matches the physical needs of the user. The TRICARE ECHO Improvement Act would codify these policies. 
  • Provides coverage of residence and vehicle adaptations. Most states with HCBS waivers cover medically necessary alterations to residences and vehicles to reduce the disabling effects of a person’s qualifying medical condition. The ECHO program, however, does not. The TRICARE ECHO Improvement Act would extend its suite of covered benefits to include such adaptations.

To ensure the ECHO program remains responsive to military families, the TRICARE ECHO Improvement Act will also require a yearly assessment of utilization rates for services, gaps in covered services and the barriers military families encounter to program access.

Bill text is available here.