ArticleGenetics in medicine : official journal of the American College of Medical Genetics2011
Eligibility criteria in private and public coverage policies for BRCA genetic testing and genetic counseling.
Article in Genetics in medicine : official journal of the American College of Medical Genetics, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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Who cites it
26 citing papers in PubMed, 45 citations in OpenAlex.
- Economic Evaluation Alongside a Clinical Trial of Telephone Versus In-Person Genetic Counseling for BRCA1/2 Mutations in Geographically Underserved Areas.Journal of oncology practice · 2016Trial
- Precision Medicine in Rural Settings: Clinician Perspectives on Clinician-Ordered Genetic Testing.Research square · 2026Article
- BRCA testing utilization among commercially insured women with breast or ovarian cancer.Breast cancer research and treatment · 2025Article
- Barriers to early detection: Insurance denials for breast MRI screening in women with germline BRCA1/2 mutations.Gynecologic oncology · 2025Article
- Article
- Medicaid Expansions: Probing Medicaid's Filling of the Cancer Genetic Testing and Screening Space.Healthcare (Basel, Switzerland) · 2022Review
- Self-rated family health history knowledge among All of Us program participants.Genetics in medicine : official journal of the American College of Medical Genetics · 2022Article
- Research to reduce inequities in cancer risk services: Insights for remote genetic counseling in a pandemic and beyond.Journal of genetic counseling · 2021Article
- Association of Patient Demographic Characteristics and Insurance Status With Survival in Cancer Randomized Clinical Trials With Positive Findings.JAMA network open · 2020Observational
- Insurance coverage does not predict outcomes of genetic testing: The search for meaning in payer decisions for germline cancer tests.Journal of genetic counseling · 2019Article
- Trends in BRCA Test Utilization in an Integrated Health System, 2005-2015.Journal of the National Cancer Institute · 2019Article
- Cancer Genetic Counseling and Testing: Perspectives of Epithelial Ovarian Cancer Patients and Gynecologic Oncology Healthcare Providers.Journal of genetic counseling · 2018Article
- Coverage of Intravenous Immunoglobulin for Autoimmune Blistering Diseases Among US Insurers.JAMA dermatology · 2017Review
- Development of a Streamlined Work Flow for Handling Patients' Genetic Testing Insurance Authorizations.Journal of genetic counseling · 2017Article
- Payer Coverage for Hereditary Cancer Panels: Barriers, Opportunities, and Implications for the Precision Medicine Initiative.Journal of the National Comprehensive Cancer Network : JNCCN · 2017Article
- EXAMINING EVIDENCE IN U.S. PAYER COVERAGE POLICIES FOR MULTI-GENE PANELS AND SEQUENCING TESTS.International journal of technology assessment in health care · 2017Article
- Validation of an Efficient Screening Tool to Identify Low-Income Women at High Risk for Hereditary Breast Cancer.Public health genomics · 2016Article
- Availability and payer coverage of BRCA1/2 tests and gene panels.Nature biotechnology · 2015Article
- Factors associated with genetic counseling and BRCA testing in a population-based sample of young Black women with breast cancer.Breast cancer research and treatment · 2015Article
- Exploring barriers to payer utilization of genetic counselors.Journal of genetic counseling · 2015Article
Corrections and comments
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Authors and funding
4 authors at 3 institutions in 1 country.
Funding
Abstract
purpose: Coverage policies for genetic services for hereditary cancers are of interest because the services influence cancer risk reduction for both persons with cancer and their family members. We compared coverage policies for BRCA genetic testing and genetic counseling among selected payers in the United States to illuminate eligibility criteria variation that may explain differential access by insurance type. We compared these policies with policies for breast cancer screening with magnetic resonance imaging to consider whether payers apply a unique policy approach to genetic services.
methods: We conducted a case study of large private and public payers selected on number of covered lives. We examined coverage policies for BRCA genetic testing, genetic counseling, and screening with magnetic resonance imaging and the eligibility criteria for each. We compared eligibility criteria against National Comprehensive Cancer Network guidelines.
results: Eligibility criteria for BRCA testing were related to personal history and family history of cancer. Although private payers covered BRCA testing for persons with and without cancer, the local Medicare carrier in our study only covered testing for persons with cancer. In contrast, Arizona's Medicaid program did not cover BRCA testing. Few payers had detailed eligibility criteria for genetic counseling. Private payers have more detailed coverage policies for both genetic services and screening with magnetic resonance imaging in comparison with public payers.
conclusion: Despite clinical guidelines establishing standards for BRCA testing, we found differences in coverage policies particularly between private and public payers. Future research and policy discussions can consider how differences in private and public payer policies influence access to genetic technologies and health outcomes.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.