More articles about Reimbursement

The partners will collaborate on clinical studies aimed at driving health plan coverage for molecular diagnostic products.

The genomic test is designed to help doctors decide which patients are at low enough risk that they can be more conservatively managed.

Payors say online, automated systems will bring standardization and efficiency to prior authorizations, but doctors and labs are uncertain about the impact on patient care.

Once these coverage decisions are fully implemented, 90 percent of breast cancer patients will have coverage for EndoPredict, Myriad estimated.

The program, called Genetic Testing Solution, went into effect July 1 among Anthem Blue Cross' fully-insured and self-insured members.

Interpace Diagnostics said that the test will now be covered for Cigna's roughly 15 million members nationwide.

The company announced positive coverage decisions from Palmetto GBA, 14 BCBS plans, and Aetna.

Starting Oct. 1, the insurer will require clinicians and labs who order genetic and molecular tests for their patients to first get approval. 

The deal with Aetna includes coverage for Interpace's ThyGenX oncogene panel and ThyraMir microRNA gene expression classifier.

The test is now covered by Premera Blue Cross, a regional health plan with more than 2 million members located primarily in Washington, Oregon, and Alaska.

The long-term pricing contract covers hereditary cancer testing, GeneSight, and a number of other diagnostics, but doesn't extend to coverage. 

The company has secured coverage for its pigmented lesion assay from CareFirst Blue Cross/Blue Shield and affiliate CareFirst BlueChoice.

The company said the number of lives now covered for EndoPredict has gone up to 109 million.

The payor has updated its medical policy to state that "the use of MammaPrint is considered medically necessary in women who are diagnosed with primary invasive breast cancer."

The decision is a quick reversal from a recent decision by the insurer not to cover fecal DNA testing and makes it the final major US insurer to cover Cologuard.

Winship's director of the cancer tissue and pathology shared resource said that some labs aren't leveraging molecular technologies due to reimbursement issues. 

The molecular testing firm estimated that more than 70 percent of Medicare patients with prostate cancer will now have coverage for Prolaris.

The genomic test is designed to identify benign thyroid nodules in patients with indeterminate fine needle aspiration biopsy results.

The coverage decision limits the test to patients with advanced lung cancers who haven't been genomically profiled and who can't receive tissue-based testing.

S.794 would require Medicare contractors to hold public meetings and disclose the rationale and evidence underlying an LCD at the start of the process.

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In a survey, about half of Canadian government scientists say they still feel as though they cannot speak freely, ScienceInsider reports.

The Atlantic reports that biohacker Josiah Zayner regrets injecting himself with the CRISPR gene-editing tool on stage.

Clinicians in China are moving ahead with a number of CRISPR trials, NPR reports, as the US embarks on its first.

In Nature this week: genomic approaches applied to study Neolithic and Bronze Age Europeans, and more.