Lawmakers and military groups are stepping up the pressure on TRICARE to reverse its noncoverage policies for many molecular diagnostic tests. More than 50 U.S. senators and representatives signed on to a Feb. 27 letter to Chuck Hagel, secretary of defense, expressing concerns regarding TriCare’s change in reimbursement policy. The letter notes that on Jan. 1, 2013, TriCare placed more than 100 molecular pathology (MoPath) tests on the No Government Pay Procedure Code List (NGPPCL) and discontinued reimbursement for these tests. “We are concerned that this policy change was not appropriately communicated to TRICARE beneficiaries or medical providers as [Department of Defense] policy requires,” write the lawmakers. “The [tests] that were placed on the NGPPCL include MoPath tests frequently used to test for diseases or conditions, including those that may develop during a pregnancy (Cystic Fibrosis, Fragile X syndrome, and spinal muscular atrophy).” The letter also notes that certain molecular pathology tests may still be covered for TRICARE beneficiaries who use a military treatment facility (MTF) but that in most cases, those same tests will no longer be covered for beneficiaries who do not have access to an MTF and who use a civilian medical provider. “We are concerned that…
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