Well thought out and informative article. Thank you for taking the time to bring attention to these critical issues.
My only question would be about your comment around NC Medicaid and what you meant by it.
NC Medicaid is actually notoriously awful for genetic testing coverage since only CMA, a handful of oncology CPT codes (and not panels), and a smattering of a few other single genes are covered and reimbursable. No Tier 2 Molpath codes are covered/reimbursable, GSP codes, no WES, etc. However, their genetic testing coverage policy (the one you linked to) is open for public comment (again) until 01/23/2023 - many genetics professionals are and have been commenting and pushing for at least WES and a few panels to be covered (some day).
Maybe I’m just not understanding what you were trying to relay, and if so my apologies.
Thanks for reaching out, Jennifer! I originally came across how coverage can depend on where the testing itself is done from Dr. Scott Gottlieb, former FDA commissioner, where he spoke at Illumina Genomics Forum last fall: https://www.youtube.com/clip/UgkxVL-iUcicCM0FnjMgVurnozoMLQswcUyI
I thought this was interesting enough to include though I’m sure everything you stated is also true. Would love to learn more from you given you have much more expertise interfacing with insurance providers than me. Sent you a LinkedIn request to connect!
Well thought out and informative article. Thank you for taking the time to bring attention to these critical issues.
My only question would be about your comment around NC Medicaid and what you meant by it.
NC Medicaid is actually notoriously awful for genetic testing coverage since only CMA, a handful of oncology CPT codes (and not panels), and a smattering of a few other single genes are covered and reimbursable. No Tier 2 Molpath codes are covered/reimbursable, GSP codes, no WES, etc. However, their genetic testing coverage policy (the one you linked to) is open for public comment (again) until 01/23/2023 - many genetics professionals are and have been commenting and pushing for at least WES and a few panels to be covered (some day).
Maybe I’m just not understanding what you were trying to relay, and if so my apologies.
Thanks for reaching out, Jennifer! I originally came across how coverage can depend on where the testing itself is done from Dr. Scott Gottlieb, former FDA commissioner, where he spoke at Illumina Genomics Forum last fall: https://www.youtube.com/clip/UgkxVL-iUcicCM0FnjMgVurnozoMLQswcUyI
I thought this was interesting enough to include though I’m sure everything you stated is also true. Would love to learn more from you given you have much more expertise interfacing with insurance providers than me. Sent you a LinkedIn request to connect!