Senators question military health program’s new lab-fee policy

A bipartisan group of senators has raised concerns about a change to the Defense Department’s health-care reimbursement policies that will force troops and their families to pay the full cost of certain tests done outside military clinics. The lawmakers, asked Defense Secretary Chuck Hagel to answer questions about how the Pentagon justified the change and communicated it to beneficiaries, as well as what the appeals process would look like for whose lab work is not covered. The change, which took effect on Jan. 1, relates to more than 100 diagnostic genetic tests. The military’s health system will still cover the tests in question, known as "molecular pathology laboratory tests," when beneficiaries use Defense Department treatment facilities, but it will not provide reimbursement for those who use civilian clinics. That’s because the Tricare program, which covers treatment at private clinics, cannot pay for laboratory work that the Food and Drug Administration has not approved. The senators said the new policy discriminates against troops and families who have limited access to military health clinics. Jonathan Woodson, the Pentagon’s head of health affairs, told a congressional subcommittee that his division was working on a fix to ensure equal reimbursement for the tests among individuals who use military and civilian clinics. "None of the beneficiaries will be denied the test that they need to get great care," he said.

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