Report shows insurance coverage of biomarker testing has not kept up with innovation

PR Newswire

WASHINGTON, Sept. 29, 2020

LUNGevity Foundation and American Cancer Society Cancer Action Network report indicates some improvement but substantial gaps still exist for many patients

WASHINGTON, Sept. 29, 2020 /PRNewswire/ — LUNGevity Foundation, the nation’s premier lung cancer-focused nonprofit organization, in partnership with the American Cancer Society Cancer Action Network (ACS CAN), issued a report today analyzing private payer health insurance coverage of biomarker testing for non-small cell lung, colorectal, breast, and prostate cancers. The study serves as an update to a similar review of health care coverage issued by both organizations in 2018.

LUNGevity Foundation logo (PRNewsfoto/LUNGevity Foundation)
LUNGevity Foundation logo (PRNewsfoto/LUNGevity Foundation)

Since 2015, LUNGevity has been working to ensure that all advanced-stage non-small cell lung cancer patients have access to comprehensive biomarker testing at diagnosis, progression, and recurrence, and have the results before making treatment decisions. LUNGevity defines comprehensive biomarker testing as a multiplex panel (also referred to as a multi-gene panel in the report, such as a Next Generation Sequencing panel) to detect multiple mutations including, at a minimum, EGFR, ALK, ROS-1, BRAF, NTRK, RET, MET, HER-2, KRAS, and an immunohistochemistry test to measure levels of the protein PDL1.

Limitations in health care insurance coverage often affect access to these vital advances, which leads to disparities in treatment. The report found that private payer health care coverage is more prominent for single-gene tests. However, health insurance companies are still slow to cover targeted multiplex panels and other forms of testing, such as minimally invasive liquid biopsies, also known as blood-based biomarker testing.

“LUNGevity is proud to partner with ACS CAN on this study as part of our ongoing commitment to improving the lives of cancer patients,” explained LUNGevity Senior Director of Public Policy Initiatives Kristen

KANSAS CITY, Mo., Sept. 29, 2020  /PRNewswire/ — Blue Cross and Blue Shield of Kansas City (Blue KC), the region’s largest healthcare insurance provider, announced today its plan to offer individual Affordable Care Act (ACA) plans for 2021. Blue KC’s portfolio of affordable products and convenient services will enhance options for those seeking coverage, especially with the offering of Spira Care in the five metro counties (Clay, Platte, Jackson, Johnson and Wyandotte), their behavioral health initiative Mindful by Blue KC, and unmatched customer service.

(PRNewsfoto/Blue Cross and Blue Shield)

  • Spira Care Centers are conveniently located throughout the metro and offer empathetic and hands-on care delivery for those living in the five-county metro. Spira Care is primary care under one roof, including quality doctors, behavioral health consultants, disease prevention, member education and more, focusing on your overall health and well-being. Those outside of the five counties where Spira Care is offered will have access to Blue KC’s trusted, extensive provider network and award-winning customer service — and the variety of plan options that offer highly competitive benefits and services to meet their healthcare needs.
  • Mindful by Blue KC is a commitment to covering the health needs of the whole person. For Blue KC members, it is a set of tools and resources to address stress, depression, anxiety, substance use and more. This ensures people can access and afford the behavioral healthcare they need. Mindful Advocates are licensed behavioral health clinicians acting as a front door to match members to providers and guide care plans — a single point of contact for a variety of behavioral health services.
  • Customer service sets Blue KC apart from others. Members ranked Blue Cross and Blue Shield of Kansas City (Blue KC) number one in Overall Customer Satisfaction among health plans in the Heartland,

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