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Independence Blue Cross to Cover MDxHealth Prostate Cancer Test

NEW YORK (GenomeWeb) – MDxHealth announced today that it has received a positive coverage determination from Independence Blue Cross for its ConfirmMDx for Prostate Cancer test.

Independence, a member of the Blue Cross Blue Shield Association (BCBSA), provides insurance coverage for patients in 32 states and Washington, DC. The company's coverage decision marks the first time a BCBSA plan has approved coverage for ConfirmMDx, MDxHealth said.

In March, the test was included in the US 2016 National Comprehensive Cancer Network (NCCN) Guidelines for prostate cancer screening. "Tests that improve specificity in the post-biopsy state — including 4Kscore, PHI, percent free PSA, PCA3, and ConfirmMDx — should be considered in patients thought to be higher risk despite a negative prostate biopsy," according to the NCCN guidelines.

ConfirmMDx is an epigenetic tissue-based test for the early detection of prostate cancer, specifically aimed at addressing false-negative biopsy concerns. It has qualified for Medicare, Medicare Advantage, and other private reimbursement plans, MDxHealth said.

"This positive coverage decision by Independence Blue Cross is a significant milestone as we work towards achieving nationwide payer adoption of our ConfirmMDx for Prostate Cancer test," said MDxHealth CEO Jan Groen in a statement. "This decision demonstrates that our investment in clinical studies and our work with managed care organizations in the US continues to yield positive results."

The company has received several positive coverage decisions in recent months. In June, the company signed a coverage agreement with Michigan-based health plan Priority Health. In August, MDxHealth received a positive medical policy decision from Cigna for ConfirmMDx. And earlier this month, ConfirmMDx was included as an in-network benefit under the California Medical Assistance Program.