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TRICARE Health Program
FALLS CHURCH, Va. — The Defense Health Agency updated its policies Sept. 21, making 25 additional laboratory developed tests (LDTs) available to TRICARE patients. The tests are offered through the DHA Evaluation of Non-United States Food and Drug Administration Approved Laboratory Developed Tests Demonstration Project. The demo allows DHA to review LDTs that have been examined by the Food and Drug Administration to determine if they meet TRICARE’s requirements for safety and effectiveness.
Newly approved LDTs include coverage of noninvasive prenatal screening tests, which allow providers to screen expectant mothers for trisomies 13, 18, 21, X and Y in singleton pregnancies with a high risk of fetal aneuploidy.
With the additions, the demonstration project now covers approximately 100 LDTs including tests for cancer diagnosis, risk and treatment; blood or clotting disorders; genetic diseases or syndromes; and neurological conditions. Some LDTs are only for a specific or rare condition, and most require prior authorization from TRICARE regional contractors. See the Full List of LDTs covered under the demo.
Generally, TRICARE only covers laboratory developed tests that have been reviewed and approved by the Food and Drug Administration. The demonstration allows the Defense Department to perform its own evaluation of a laboratory developed test, establish a list of these tests deemed safe and effective and establish a process to add new tests to that list.
TRICARE patients must get prior authorization from their regional contractor for an LDT to be covered, except for the tests for preconception and prenatal cystic fibrosis carrier screening. You can learn more about the LDT demonstration project and find contact information for the regional contractors on the TRICARE website.
The demonstration project is an important step in achieving greater parity between direct and private sector care and ensuring TRICARE patients have access to the full array of proven health services, technologies, and products available in the United States.