Public and private payers vary in the level of evidence they require to cover genetic tests and precision medicine services, according to the AMA. To address this issue, the organization’s physician members voted to encourage the development of a comprehensive strategy that facilitates standardized payer coverage determinations.
Under the vote, the AMA’s policy encourages public and private payers to adopt processes and methodologies that promote transparency; include input from genetic test developers and clinical experts; and provide opportunities for comment and review; among other considerations.
“Many patients do not have access to precision medicine because most public and private health insurers do not offer coverage for genetic or genomic services unless certain clinical criteria and evidentiary standards are met,” said AMA Board Member William E. Kobler, MD. “As a result, access to this next generation of clinical testing services is often limited.”
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