Tricare, which provides medical services for military families and retirees, has stopped reimbursing clinical laboratories for more than 100 molecular pathology tests, saying that new CPT codes for these tests have provided greater transparency into what it has been paying for and that it believes many of the tests it previously paid for should not be covered. According to a report in Stars and Stripes, the Defense Health Agency says the new codes allow the agency to “identify specific laboratory tests that 1) have not been approved or cleared by the Food and Drug Administration and/or 2) failed to meet Tricare criteria for coverage.” Among the tests that are no longer covered is a genetic test to determine if a woman who is pregnant carries a marker for cystic fibrosis, which would increase the chance of the baby having the disease. In a Jan. 9 letter to the assistant secretary of defense for health affairs, the Military Coalition, a consortium of military and veterans organization representing more than 5.5 million members plus their families and survivors, said the lack of Tricare reimbursement for these laboratory tests creates two standards of care for uniformed service members, retirees, and their families. “Beneficiaries…
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