US Medicare Agency Proposes Expanding Coverage Of Next-Generation Sequencing For Advanced Cancers
There is sufficient evidence to expand coverage of next-generation sequencing (NGS) as a diagnostic test for ovarian, breast or other advanced cancers if certain criteria are met, the Centers for Medicare and Medicaid Services wrote in a 30 October proposed decision memo.
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The US Centers for Medicare and Medicaid Services (CMS) has finalized many new coverage policy decisions and coverage rules taking effect in 2020. Medtech Insight provides a review of what industry can expect this year from the Medicare agency.
The CMS opened a national coverage analysis tracking sheet on 29 April to reconsider evidence for next-generation sequencing tests of germline mutations. These assays identify beneficiaries with hereditary cancer who may benefit from targeted treatments based on the tests’ conclusions about carcinogenic genetic mutations passed on by patients’ parents.
While device firms that create lab test kits, clinical laboratories and cancer medicine groups supported US Centers for Medicare and Medicaid Services' proposed national coverage determination for use of next generation sequencing (NGS) for advanced cancer tests in recent comments, they want the agency to modify its approach to the NCD in one way or another and, in many cases, expand it. A final coverage decision is imminent.