CMS eyes expanding Medicare coverage of DNA tests for breast, ovarian cancer

Doctor with inpatient
CMS has proposed expanding next-gen sequencing testing for certain types of breast and ovarian cancers. (Getty/Ridofranz)

The Trump administration has proposed expanding Medicare coverage of next-generation sequencing as a diagnostic laboratory test for certain types of ovarian and breast cancer.

The proposed decision memo released on Tuesday would help identify inherited mutations in patients that could have hereditary forms of ovarian or breast cancer.

“Laboratory diagnostic tests using [next-generation sequencing] can provide a genetic profile of a patient’s cancer cells and may help clinicians identify the most effective course of treatment — which is why we’ve been actively monitoring the rapid innovation of these tests,” tweeted Seema Verma, administrator of the Centers for Medicare & Medicaid Services.

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To obtain coverage for the test, a patient has to have ovarian or breast cancer, have clinical indications for inherited testing and not been previously tested using next-generation sequencing.

CMS has approved next-generation sequencing tests before for other types of cancers.

In March 2018, the agency finalized coverage for the first time of next-generation sequencing for patients with advanced cancers. The tests could be used as a companion diagnostic to identify certain mutations that could benefit from targeted treatments, CMS said back in March.

CMS will hold a 30-day public comment period on the proposal to expand next-gen sequencing tests for ovarian and breast cancer.