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Coverage Expands for Cologuard Stool DNA Test for CRC Screening
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Health Care Service Corp., the fourth largest health insurer in the U.S., and Florida Blue have updated their medical policies to cover Cologuard, the FDA-approved multi-target stool DNA test for noninvasive colorectal cancer screening, the manufacturer announced.
As a result, 18 million people insured by these health plans will now have coverage for Cologuard (Exact Sciences), for a total of 80 million people covered by commercial plans. Including Medicare, Cologuard is now covered for 62% of its target population, according to a press release.
“We are pleased that Cologuard’s commercial coverage continues to broaden following its inclusion in the recently-updated U.S. Preventive Services Task Force colorectal cancer screening recommendations,” Kevin Conroy, chairman and CEO of Exact Sciences, said in the press release. “As health plans continue to update their coverage policies to include Cologuard, an increasing number of people have access to an innovative, non-invasive colorectal cancer screening option.”
HCSC’s policy, effective August 15, considers Cologuard may be medically necessary for colorectal cancer screening every 3 years for average risk patients not up to date with screening. Florida Blue’s updated policy similarly indicates Cologuard may be medically necessary once every 3 years based on the USPSTF recommendations, according to the press release.
Disclosures: Conroy is employed by Exact Sciences.