After legislative push, last national payer holdout commits to covering DBT

Following a push by a bipartisan group of U.S. lawmakers, the Department of Defense has committed to covering digital breast tomosynthesis (DBT) for service members and their families.

Assistant Secretary of Defense Thomas McCaffery recently confirmed this TRICARE change in a letter to members of Congress. Provisional DBT coverage will begin for services rendered on or after Jan. 1, 2020, with the agency working to ensure full coverage sometime early next year.

Sen. Martha McSally (R-AZ)—who recently introduced legislation to require coverage of DBT for servicewomen—applauded the policy change on Dec. 3.

“I’m glad to see the Department of Defense step up and provide needed coverage for DBT screenings to our active-duty service members and others,” she said in a statement“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.”

In his letter, McCaffery noted that TRICARE’s provisional coverage authority provides an avenue to pay for “emerging healthcare services and supplies.” However, the U.S. Preventative Services Task Force currently does not recommend DBT for breast cancer screenings. He hopes the task force will eventually change its policy, but until then, the provisional coverage can be extended for up to five years.

The Medical Imaging and Technology Alliance (MITA) also praised the policy change on Friday, while urging McSally and colleagues to continue pushing their legislation. Prior to this policy change, TRICARE was the last remaining national payer that did not cover DBT, MITA noted.

“This is a major step forward, but more work remains to be done,” Dennis Durmis, chair of the MITA Board of Directors, said in a separate statement.