Medicare Partially Covers Genetic Prostate Cancer Test

Medicare Partially Covers Genetic Prostate Cancer Test
Medicare is starting to cover genetic prostate cancer tests and is considering the possibility to expand the coverage to a national level. The U.S. national health care program is going to provide diagnostic examination to assess the risk of developing prostate cancer in men, and is also planning on consulting healthcare stakeholders, in order to evaluate the viability of offering it nationwide, as announced by a Medicare administrative contractor. Even though the disease is the second most common type of cancer diagnosed in American men, causing the death of approximately 28,000 people, according to the Centers for Disease Control and Prevention, Medicare does not cover genetic prostate cancer tests, which are key in assessing a patient's probability of suffering from the disease. Even now, when it has decided to partially cover Prolaris, an exam developed by the publicly traded biotechnology company Myriad Genetics, there are several conditions. In order to receive the Prolaris test, patients must meet a series of criteria, including being considered low risk or very low risk, having a life expectancy of at least ten years and having the test ordered by a certified clinician from Myriad's database, according to the local coverage determination proposed by the Centers for Medicare & Medicaid Services (CMS), which can be fully consulted here. The coverage will be submitted to a public comment period, which will last between November 10 and December 25. During this time, Myriad will provide information to Medicare that they believe will help support the national coverage of the test to all patients, and not only the low risk ones, as stated by a spokesman of the company. If Medicare approves the national coverage of the genetic prostate cancer t
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