Thursday, October, 25
NGS Oncology Panel Reimbursement: What Does the Future Hold Now that CMS has Issued an NCD?
Track: Billing, Coding & Reimbursement
4:50 pm - 5:40 pm
Columbia A

Speaker

Description

In March 2018, the Centers for Medicare & Medicaid Services (CMS) issued a final National Coverage Determination (NCD) for patients who receive next generation sequencing (NGS) testing with an assay that meets coverage criteria for solid tumor patients with Stage III and Stage IV, metastatic, recurrent, relapsed, or refractory cancers.

This is a major milestone in payer acceptance for NGS oncology panels.

But what will be the effect on other payers? Will others follow suit? Will they have more or less restrictive coverage indications? And how fast will they act?

This presentation will examine the various positions that different payers have taken on NGS oncology panels in 2018, and highlight the rationale behind their existing polices.

We will also review case studies examining historical patterns of coverage for other high profile, clinically impactful technologies that have gone through the CMS NCD process.

What can history tell us about the future?

After this session, attendees able to:

  • translate key implications of the recent CMS NCD for Next Generation Sequencing
  • apply historical benchmarks to under the likely impact on commercial payers
  • distinguish nuances across payer segments when evaluating new technologies

Documents

NGS Oncology Panel

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