Hagan, Burr Lead Members of Congress in Urging Secretary Hagel to Restore TRICARE Coverage of Critical Medical Tests

Federal Information & News Dispatch, Inc.

TRICARE has stopped covering standard tests, threatens to create two standards of care for military families and retirees

February 28, 2014

Contact: Chris Moyer 202-379-8421

Chris Hayden

919-325-6000

Press@hagan.senate.gov

Washington, DC - Today, U.S. Senators Kay Hagan and Richard Burr led a bipartisan group of Senate and House members in sending a letter to Secretary of Defense Chuck Hagel expressing concerns regarding TRICARE's sudden change in reimbursement policy for critical medical tests. Beginning January 1, 2013, Tricare stopped covering many routine lab tests for servicemembers, their dependents and retirees

"These tests provide useful information to help physicians determine the best course of treatment for their patients and are widely considered by the medical community to be the normal standard of care," Hagan said. "Our military families have sacrificed so much for our country and shouldn't be forced to pay out of pocket for routine lab tests that are available to most patients."

To read a copy of the letter, go to: http://www.hagan.senate.gov/files/documents/140227LDTLetter.pdf.

The tests TRICARE has stopped covering are screenings for cystic fibrosis, Fragile X syndrome, spinal muscular atrophy, and common cancers. These tests are considered "standard of care" by medical professionals and are covered by most major health insurance companies.

However, TRICARE has continued to cover these same tests if they are performed at Military Treatment Facilities (MTF), which are located on military bases, such as Fort Bragg. Yet many patients lack access to an MTF because they live too from such a facility or are forced to see civilian providers off-base because of a MTF's limited resources. In these cases, TRICARE is not reimbursing tests performed through a civilian provider.

"We are concerned that TRICARE's decision will jeopardize patient access to [these tests] and ultimately could create two levels of care within the Military Health System and the TRICARE network: one that discriminates against beneficiaries who have limited access or are unable to access a MTF and one that does not," wrote Hagan and Burr, along with 26 Democrats and 25 Republicans.

Furthermore, upon changing its coverage policy, TRICARE failed to notify patients and medical providers. "We are concerned that this policy change was not appropriately communicated to TRICARE beneficiaries and medical providers as DoD policy requires," wrote the Members of Congress.

TRICARE is the health care program for service members (active, Guard/Reserve, retired) and their families around the world. For more information about TRICARE, please go to: http://www.military.com/benefits/tricare.