Medicare and Insurance Policy Updates in 2023 Will Improve … – Yahoo Finance

MADISON, Wis., Dec. 20, 2022 /PRNewswire/ — Exact Sciences Corp. (NASDAQ: EXAS), a leading provider of cancer screening and diagnostic tests, supports recent policy changes that help increase access to recommended non-invasive colorectal cancer screening tests. These policy changes require Medicare and most commercial insurers to pay for colonoscopy after a positive Cologuard® test without cost to the patient. For most patients, these financial protections take effect starting January 1, 2023.
“This is a huge win for our patients,” said Dr. David Lieberman, gastroenterologist and AGA committee chair.
Exact Sciences is the maker of Cologuard, an FDA-approved, noninvasive stool-based DNA and hemoglobin screening test for adults 45 and older who are at average risk for colorectal cancer (CRC). Since its launch in 2014, more than 10 million Cologuard tests have been completed, allowing patients to provide screening samples in the privacy of their homes. Recent data from Exact Sciences, published in the American Journal of Gastroenterology, found that eliminating patient cost sharing for follow-up colonoscopy can lead to positive shifts in test use patterns, increase overall participation rates, and improve both economic and clinical outcomes.[i] 
“This is a huge win for our patients. This change will help providers address a major CRC screening gap for people who were previously burdened by the cost of a follow-up colonoscopy,” said Dr. David Lieberman, gastroenterologist, and chairperson of the American Gastroenterological Association committee on CRC screening. “We know disparities exist in CRC screening. There are data which show that when we increase access to colorectal cancer screening and help navigate patients needing a follow-up colonoscopy after a non-invasive screening test, those disparities are greatly reduced.”
Non-invasive screening provided crucial options during the pandemic. However, patients have noted that out-of-pocket costs for colonoscopy following positive stool-based testing, remain a barrier to increasing CRC screening rates.[ii]
“As a cancer diagnostics leader, we must continue to partner with all stakeholders across healthcare to increase access and make it easy for all Americans to receive recommended cancer screenings,” said Kevin Conroy, Chairman and CEO of Exact Sciences. “These changes help remove a key financial barrier.”
Cancer advocacy organizations led the efforts to eliminate out-of-pocket cost barriers to screening. Together, the American Gastroenterological Association, the American Cancer Society Cancer Action Network, and Fight Colorectal Cancer, formed a coalition of advocacy groups and industry partners, including Exact Sciences, to improve these policies for patients.
“Non-invasive colorectal cancer screening tests are an important tool in the fight against colorectal cancer, particularly in light of challenges patients have faced due to COVID-19, and as we expand our efforts to reach medically underserved communities,” said Anjee Davis, MPPA, president of Fight Colorectal Cancer. “This guidance will help ensure that patients can choose the test that is best for them without worrying about out-of-pocket costs for a follow-up colonoscopy. Ultimately, we believe this will save lives and support an increase in the early detection of colorectal cancer.”
These policy updates come from further implementation of Affordable Care Act (ACA) guidelines and revised regulations adopted by the Centers for Medicare and Medicaid Services (CMS). CMS designed the changes to, “Expand access to quality care and improve health outcomes through early detection, more effective treatment, and reduce mortality.”[iii] For most Medicare beneficiaries and commercially-insured patients, no cost sharing will be incurred for either a Cologuard test or a follow-on colonoscopy. The changes may not apply to certain commercial plans exempted under the ACA.
About Exact Sciences Corp.
A leading provider of cancer screening and diagnostic tests, Exact Sciences relentlessly pursues smarter solutions providing the clarity to take life-changing action, earlier. Building on the success of Cologuard® and Oncotype® tests, Exact Sciences is investing in its product pipeline to support patients before and throughout their cancer diagnosis and treatment. Exact Sciences unites visionary collaborators to help advance the fight against cancer. For more information, please visit the company’s website at www.exactsciences.com, follow Exact Sciences on Twitter @ExactSciences, or find Exact Sciences on Facebook and LinkedIn.
About Cologuard
The Cologuard test was approved by the FDA in August 2014, and results from Exact Sciences’ prospective 90-site, point-in-time, 10,000-patient pivotal trial were published in the New England Journal of Medicine in March 2014. The Cologuard test is included as a non-invasive screening option in the American Cancer Society’s (2018) colorectal cancer screening guidelines and the recommendations of the U.S. Preventive Services Task Force (2021) and National Comprehensive Cancer Network (2016).
The Cologuard test is indicated to screen adults 45 years of age and older who are at average risk for colorectal cancer by detecting certain DNA markers and blood in the stool. Do not use the Cologuard test if you have had adenomas, have inflammatory bowel disease and certain hereditary syndromes, or have a personal or family history of colorectal cancer. The Cologuard test is not a replacement for colonoscopy in high risk patients. The Cologuard test performance in adults ages 45-49 is estimated based on a large clinical study of patients 50 and older. The Cologuard test performance in repeat testing has not been evaluated.
The Cologuard test result should be interpreted with caution. A positive test result does not confirm the presence of cancer. Patients with a positive test result should be referred for colonoscopy. A negative test result does not confirm the absence of cancer. Patients with a negative test result should discuss with their doctor when they need to be tested again. False positives and false negative results can occur. In a clinical study, 13% of people without cancer received a positive result (false positive) and 8% of people with cancer received a negative result (false negative). Medicare and most major insurers cover the Cologuard test. For more information about the Cologuard test, visit cologuard.com. Rx only.
[i] Fendrick AM, Chen JV, Ozbay AB, Vahdat V, Limburg PJ. S266 Lifetime Impact of the Change in Modality as a Result of Eliminating Cost-Sharing for Follow-Up Colonoscopy After a Positive Stool Test for Colorectal Cancer Screening. Am J Gastroenterol. 2022;117(10)Se189-e190. doi:10.14309/01.ajg.0000857704.03887.bd https://journals.lww.com/ajg/Fulltext/2022/10002/S266_Lifetime_Impact_of_the_Change_in_Modality_as.266.aspx
[ii]A.M. Fendrick, N. Princic, L.-A. Miller-Wilson, K. Wilson, P. Limburg, Out-of-Pocket Costs for Colonoscopy After Noninvasive Colorectal Cancer Screening Among US Adults with Commercial and Medicare Insurance
[iii] Fact sheet Calendar Year (CY) 2023 Medicare Physician Fee Schedule Final Rule. CMS. Updated November 1, 2022. Accessed December 8, 2022. https://www.cms.gov/newsroom/fact-sheets/calendar-year-cy-2023-medicare-physician-fee-schedule-final-rule
Media (U.S.):                                           
Investors:                                             
Lindsey Dickinson                                              
Megan Jones
+1 608-690-0383                              
+1 608-535-8815                                     
lidickinson@exactsciences.com                      
meganjones@exactsciences.com
View original content to download multimedia:https://www.prnewswire.com/news-releases/medicare-and-insurance-policy-updates-in-2023-will-improve-cancer-screening-access-by-removing-patient-colonoscopy-cost-following-a-positive-cologuard-test-301707315.html
SOURCE EXACT SCIENCES CORP
Related Quotes
A kidney disease treatment from Vera lagged rivals from Chinook and Otsuka, analysts said Wednesday as the biotech stock plummeted.
As 2023 starts gearing up for the long haul, Wall Street is still taking a bearish view of the markets. We’re still dealing with the same headwinds, a combination of stubbornly high inflation, rapidly rising interest rates, gloomy economic indicators, the continuing war in Ukraine, uncertainty over China’s lockdown policies, a supply chain that is only slowly unsnarling itself… the list can go on. But despite the grim outlook right now, there are still some signals that give reasons for longer-t
Yahoo Finance's Dave Briggs discusses General Electric's health care spinoff hitting public markets on Wednesday.
After releasing topline late-stage clinical trial data on its drugs effect on a set of precancerous conditions, a longtime Bay Area biotech said it plans to raise $175 million through a stock sale. Geron Corp. (NASDAQ: GERN) said early Wednesday that its drug, called imetelstat, met the primary efficacy goal in a Phase III study in certain patients with myelodysplastic syndromes, or MDS. The company said it will submit the data to the Food and Drug Administration as it asks the agency this year to approve the drug.
Walt Disney would probably approve as he was never a fan of any vices at his company's theme parks.
(Bloomberg) — General Electric Co.’s former medical-equipment business surged in its trading debut as investors got their first chance to bet on the now-independent company.Most Read from BloombergShopify Tells Employees to Just Say No to MeetingsWhy Conservatives Are Blocking McCarthy as Speaker — and Throwing Congress Into ChaosFed Affirms Inflation Resolve, Pushes Back Against Rate-Cut BetsIf You Have Student Loans, Mark These Dates on Your CalendarShares of GE HealthCare Technologies Inc. r
VERA posts positive top-line data from the phase IIb ORIGIN study evaluating atacicept for the treatment of IgA nephropathy.
Chemomab's (CMMB) phase II study evaluating CM-101 in NASH patients met its primary endpoint of safety and tolerability.
Is Pfizer stock a buy or a sell after getting a downgrade on its falling Covid-tied sales? Is PFE stock a buy or a sell right now?
The "Snake" and "Pull Up" rapper suddenly died in May 2022 at the age of 24.
Contrary to what you may have heard, these foods can help you stay nourished and support your health goals.
In downtown Boulder, Colorado, a public library that provides the surrounding community with a space to meet and learn has been closed for two weeks. No, winter weather was not to blame. Overdue books weren’t the cause, and neither was funding. It was meth. The main library in Boulder, about 30 miles northwest of Denver, was shut down Dec. 20 when test results from restroom exhaust vents showed methamphetamine contamination, the city said in a statement. Sign up for The Morning newsletter from t
GSK's specialty products like Dovato, Nucala, Trelegy Ellipta and Shingrix are likely to drive sales, making up for the lower sales of established drugs due to generic erosion.
Jill Biden's doctor said that the First Lady has a "small lesion" above her right eye that was found during a routine check-in, and said it'll be removed.
The global health body is now trying to figure out how severe the sub-variant is.
Americans are predicted to waste hundreds of millions of pounds on unused memberships in 2023, but a health guru at global gym brand Anytime Fitness has shared his tips on how to keep up the habit.
We're in the middle of a possible "tripledemic," as RSV, the flu and COVID cases are rising sharply in America. "COVID-19 may have lost its daily news headline status, but the disease rages on with 2700 weekly deaths in the U.S. and millions of Americans chronically disabled from long-COVID, 4 million of which are being kept from work. This winter time, a terrible year for RSV as well as a potentially worse flu season could add insult to injury especially when one considers the fact that COVID-1
Biogen and Eisai are jointly developing lecanemab. A decision on accelerated approval is expected by Friday.
Health professionals speak on important takeaways of Damar Hamlin's injury on Monday night
Christina McKnight, now 35, thought little of her symptoms and was only diagnosed after her husband ‘forced’ her to see a doctor

source

Leave a Comment