Some TRICARE beneficiaries will soon be able to take advantage of new technologies aimed at helping patients and healthcare providers make more informed decisions regarding treatment options for surgery, chemotherapy or radiation therapy for some types of cancer.
On May 22, 2012, two laboratory developed tests were approved for coverage by TRICARE under a demonstration project: the BRACAnalysis BRCA1 and BRCA2 tests (Myriad Genetic Laboratories, Inc.), and also, the Oncotype DX Breast Cancer Assay (Genomic Health, Inc.).
BRACAnalysis testing assesses a woman’s risk of developing hereditary breast or ovarian cancers based on detection of mutations in their BRCA1 and BRCA2 genes. The Oncotype DX breast cancer assay is a test that examines a breast cancer patient’s tumor tissue at the molecular level; specifically, it is hoped that this information can help individualize the planning of the patient’s breast cancer treatment. The complete description of this demonstration project is available at www.gpo.gov/fdsys/pkg/FR-2011-12-27/html/2011-33066.htm.
The criteria for which of these tests will be covered by TRICARE are scheduled to be published in the TRICARE Operations Manual in August 2012. TRICARE providers will be prepared to accept patients under the demonstration project by September 30, 2012; however, coverage for the approved use of these tests is retroactive to May 22, 2012. Beneficiaries should speak with their primary health care professional or their regional contractor to determine their eligibility for having these tests performed as a TRICARE benefit. Find regional contractor contact information at www.tricare.mil/contactus.