U.S. SENATE—U.S. Senator Martha McSally (R-AZ) secured confirmation from the Department of Defense that the most effective breast cancer screening option is now available for active-duty female servicemembers and others covered under Tricare.
Assistant Secretary of Defense for Health Affairs Thomas McCaffery wrote to McSally to report that her request to add Digital Breast Tomosynthesis (DBT), to TRICARE’s coverage, was approved.
“I am pleased to report that I recently approved adding DBT for screening purposes to the TRICARE benefit under TRICARE’s provisional coverage authority, which can allow coverage for emerging healthcare services and supplies,” McCaffery wrote. “This coverage will be effective for services rendered on or after January 1, 2020, and the Defense Health Agency is working to ensure full implementation in early 2020.”
McCaffery’s letter comes after McSally introduced the Better and Robust Screening Today Act that would require the Department of Defense (DoD) to cover DBT screenings. In September, McSally also led a bipartisan letter requesting this expanded coverage.
“I’m glad to see the Department of Defense step up and provide needed coverage for DBT screenings to our active-duty servicemembers and others,” McSally said. “This commonsense change will benefit the many women who utilize Tricare. I urge the United States Preventive Services Task Force to recommend DBT for breast cancer screening to ensure permanent coverage of this much needed service.”
Dear Senator McSally:
Thank you for your inquiry of September 30, 2019, regarding TRICARE’s coverage of Digital Breast Tomosynthesis (DBT), also called “3D mammography” for breast cancer screening. We greatly appreciate the opportunity to address your concerns.
I am pleased to report that I recently approved adding DBT for screening purposes to the TRICARE benefit under TRICARE’s provisional coverage authority, which can allow coverage for emerging healthcare services and supplies. This coverage will be effective for services rendered on or after January 1, 2020, and the Defense Health Agency is working to ensure full implementation in early 2020. Since the United States Preventive Services Task Force (USPSTF) does not currently recommend DBT for breast cancer screening, I could only approve provisional coverage at this time. This provisional coverage can be extended for up to five years, during which time we are hopeful that the USPSTF will recommend DBT for breast cancer screenings.
By federal regulation, TRICARE follows the USPSTF recommendations for coverage of preventive and screening procedures. However, we recognize that DBT is rapidly becoming the standard of care across the U.S. TRICARE has received many requests to include DBT screenings in our coverage. As a result of the evolving role of this technology in the health care field, we have taken steps to evaluate and amend our coverage.
TRICARE already added coverage of DBT this past August for diagnostic purposes when a physician finds it necessary (for example, if a patient presents with symptoms). Patients and providers should contact the appropriate Managed Care Support Contractor in their region for more information, at www.tricare.mil/contactus.
Thank you for your interest in the health and well-being of our Service members, veterans, and their families.
Thomas P. McCaffery