[HEALTH.MIL] Tricare Will Again Cover Breast Cancer Tests

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  • Date: Mon, 6 Aug 2012 13:06:24 -0500

Tricare Will Again Cover Breast Cancer Tests

By Patricia Kime - Staff writer
Posted : Friday Aug 3, 2012 13:50:07 EDT

Genetic tests for breast cancer gene mutations will again be covered for some
Tricare beneficiaries under a new program, the Pentagon announced this week.

Tricare providers will accept patients for the tests, commonly known as BRCA1
and BRCA2, beginning Sept. 30. Coverage will be retroactive to May 22, according
to a release from the Tricare Management Activity.

The Oncotype DX Breast Cancer Assay, a test that analyzes tumor tissue at the
molecular level, also will be covered under the same demonstration program,
according to Tricare.

Before this year, Tricare or the individual services offered the BRCA cancer
screenings for high-risk individuals under special programs, research projects
and at some military treatment facilities. But in January, Tricare stopped
covering the tests after a decision by the American Medical Association placed
the non-FDA approved screenings on the Pentagon's "No Government Pay List."

Under federal regulations, the tests are considered "medical devices" that
cannot be cost-shared because they do not have approval from the Food and Drug

To again offer the screenings, Tricare placed them in a pilot project designed
to "determine whether they are safe and effective."

The pricey screenings, which cost up to $2,000, will not be available to all

The criteria for which tests will be covered and for whom - usually individuals
with one or more close relatives who have had breast cancer or those already
diagnosed with certain tumors - will be published by Tricare in August.

In April, Sen. Jon Tester, D-Mont., a member of the Senate Cancer Coalition,
implored the Defense Department to offer the screenings. He wrote Assistant
Secretary of Defense for Health Affairs Dr. Jonathan Woodson urging Tricare to
reconsider its payment procedures.

On Wednesday, Tester called the Pentagon's decision "a victory" for service
members, retirees and families.

"This safe test will make a big difference in women's lives, and I will keep
fighting to make sure that red tape doesn't prevent our troops and their
families from receiving the quality health care they earned," Tester said.

One in eight women nationwide will develop breast cancer.

According to the Clinical Breast Care Project at Walter Reed National Military
Medical Center, more than 2,000 cases of breast cancer have been diagnosed in
active-duty service members in the past decade.

SOURCE:  Army Times article at http://www.armytimes.com/news/

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