One of InformedDNA’s core tenets has always been to increase access to valuable genetic expertise, regardless of patient location. While we have done this by building the first national telehealth-based genetic counseling service, there continues to be a barrier to reaching a key population in need to genetics expertise: Medicare beneficiaries.
On June 12, 2019, the “Access to Genetic Counselors Act of 2019” (H.R. 3235) bill was introduced to the U.S. House of Representatives. It would authorize the U.S. Centers for Medicare and Medicaid Services (CMS) to recognize certified genetic counselors (CGCs) as health care providers. This bill has bi-partisan sponsorship, sponsored by U.S. Rep. Dave Loebsack (D-Iowa) and U.S. Rep. Mike Kelly (R- Pennsylvania).
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 health care providers who are key to the understanding, utilization and growth of personalized genetic medicine applications. H.R. 3235 will help to correct this discrepancy and bring Medicare in line with many commercial health plans across the country.
Current CMS rules require that Medicare beneficiaries only see a genetic counselor under the 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, he/she 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.
Research has shown that genetic counselors, when involved in the genetic testing process, actually help to avoid unnecessary testing and associated medical expense. In fact, we find that approximately 20 percent of patients who receive counseling from one of our certified genetics specialists make an informed, empowered decision not to pursue testing. With this type of guidance removing the need for involvement of a second healthcare provider as described above, factors into projections that H.R. 3235 would save Medicare up to $6.5 billion over 10 years, while improving the access to quality genetics-informed health care.
With an estimated 10 new genetic tests hitting the market daily, and more than 75,000 tests currently available, the public needs access to genetic counselors now more than ever. There are three primary ways in which the bill has the potential to improve quality of care and health outcomes while making a deep impact on costs.
- Eliminate disparities in care for low-income and elderly patients.
- Change the way in which providers and genetic counselors interact with one another.
- Support more informed decision-making around genetic testing and therapies.
To read more about these benefits, please refer to Dr. Rebecca Sutphen’s article about last year’s H.R. 7083, “Access to Genetic Counselor Services Act of 2018,” in Medical Economics.
The National Society of Genetic Counselors supports H.R. 3235 and ask that friends and utilizers of the genetic counseling profession reach out to their congressional representatives to request their support of this bill. Please take a few minutes to support the new bill by sending a letter to your Congressional Representative using one of the following links:
InformedDNA is proud to be the leading employer of experienced genetic specialists in the U.S., currently employing more than 80 full-time, board-certified genetic counselors in varied roles nationwide. To learn more about our genetic counseling and other services, please contact us:
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