InformedDNA is very proud to be one of the leading employers for experienced genetic counselors, currently employing nearly 100 board-certified genetic counselors in varied roles nationwide. InformedDNA’s vision remains the same: Improve access to clinical and scientific genomics expertise to optimize patient outcomes and healthcare spending.
While InformedDNA built the first telehealth-based genetic counseling service in the U.S. back in 2007 and has provided more than 100,000 genetic counseling sessions to patients, there has continued to be a barrier to reaching a key population in need of genetics expertise: Medicare beneficiaries.
Despite multiple bills being introduced in the past, competing priorities of the legislative sessions have caused the timing to run out before a vote has even been completed. However, in 2021, momentum is strong. The Access to Genetic Counselor Services Act was introduced to the U.S. House of Representatives on March 23 (H.R. 2144) and introduced to the U.S. Senate on April 29 (S. 1450). H.R. 2144 was introduced by U.S. Rep. Brian Higgins (D-NewYork) and S. 1450 by U.S. Senator Jon Tester (D-Montana) and U.S. Senator John Barraso (R-Wyoming). Both bills have bipartisan sponsorship, as well as backing by more than 250 organizations representing physicians, patients, hospitals, laboratories, and other healthcare providers.
On passing, these bills will authorize the U.S. Centers for Medicare and Medicaid Services (CMS) to recognize certified genetic counselors (CGCs) as healthcare providers. Medicare policy currently pays for genetic testing and for genetic counseling, but not when the genetic counseling is performed by genetic counselors. This, unfortunately, creates barriers for access to these specially trained healthcare providers who are key to optimizing understanding, integration, and growth of personalized genetic medicine applications.
Genetic counselors have advanced training in medical genetics and counseling to guide and support patients seeking more information about how inherited diseases and conditions might affect them or their families, and to interpret genetic test results based on your personal and family history.
Source: National Society of Genetic Counselors
Current CMS rules require that Medicare beneficiaries can only see a genetic counselor under the direct supervision of a physician currently caring for them, also known as “incident to.” If a patient is under the care of a practice or center that does not employ its own genetic counselors, they must be referred first to a physician in a competing center and then seen by the associated genetic counselors. These extra steps are not only a financial barrier, but a time and relationship barrier to services for these patients.
Additionally, direct supervision requirements prohibit genetic counselors from reaching Medicare beneficiaries utilizing telehealth, even though multiple studies have found that remote genetic counseling services are as effective as the in-person alternative, and preferred by the majority of patients.
More recently, during the COVID-19 pandemic, the rapid growth of telehealth services and the swift adaptation of commercial insurers to allow for the use of remote care models only served to increase the discrepancies in access for Medicare beneficiaries due to the lack of payment for genetic counselors regardless of delivery model. The Access to Genetic Counselor Services Acts will help to correct this discrepancy and bring Medicare in line with many commercial health plans across the country.
Research has shown that genetic counselors, when involved in the genetic testing process, actually help to save significant health care dollars. Healthcare spending is a key issue in the U.S., and increasing access to genetic counselors ensures appropriate genetic testing, as well as accurate utilization of genetic testing results, by ensuring access to genetics experts as part of the patient’s care team. This is projected to save Medicare up to $6.5 billion over 10 years while improving quality care at a time when spending on personalized healthcare is projected to grow exponentially.
With more than 30 new genetic tests hitting the market daily, and an estimated 150,000 tests currently available, the public needs access to genetic counselors now more than ever. The bills under consideration present important ways to improve the quality of care and health outcomes while making a deep impact on costs.
Show Your Support for Increasing Access to Genetic Counselor Services
The National Society of Genetic Counselors, many industry service providers, and InformedDNA support H.R. 2144 and S. 1450 and ask that friends and patrons of the genetic counseling profession reach out to their representatives to request their support of this bill. It only takes a few minutes, and letters can be sent using one of the links below.
Just use one of the following links to send a letter to your U.S. Representative:
Use this link to customize a letter to your U.S. Senators.
If you’d like to learn more about InformedDNA and the expert genetics services we offer for health plans, health systems and hospitals, and pharmaceutical companies, please get in touch – just fill out the short form below, or give us a call: 844-846-3763.