Cigna rolls out new coverage policy for whole exome sequencing

InformedDNA CEO David Nixon

Cigna ($CI) is teaming up with genetic counseling company InformedDNA for a new policy for whole exome sequencing, building on the pair's past work to lay out new standards for covering the technology. 

Requests for whole exome sequencing, or a complex test that analyzes all of the genes and their coding sections, are on the rise, growing by 10% per quarter, Cigna said in a statement. But there's still not much framework to determine if genetic tests are necessary, and that's where Cigna's new policy comes in.

The policy establishes an "appropriate clinical structure" that could help providers figure out whether or not they need to order genetic testing, and builds on an earlier policy statement from the American College of Medical Genetics that called for pre- and post-test consultation with a genetics professional.

"Not all genetic tests have clinical value, nor are they appropriate for the entire population, just like a new medication wouldn't be right for everybody," Jeffrey Hankoff, Cigna's medical officer for clinical performance and quality, said in a statement. "This coverage policy provides the clarity that healthcare professionals need and will help them and their patients make informed decisions to drive improved clinical outcomes."

The policy builds on previous work between InformedDNA and Cigna. Back in 2013, the two rolled out a program that offered genetic counseling to patients who were considering getting tested for certain diseases including hereditary cancer.

InformedDNA said it would lend its genetic counseling service to the initiative, making sure that patients get counseling from a licensed, independent board-certified genetic specialist to see if they're at greater risk for breast cancer, colorectal cancer or Long QT syndrome, the company said at the time. Genetic counselors will use an individual's and family's health history to offer tailored recommendations, potentially guiding prevention, diagnostic and treatment efforts.

Under the agreement, St. Petersburg, FL-based InformedDNA also offered support and quality assurance to Cigna's Coverage Policy Unit and utilization management medical directors. The program could grow over time, as personalized medicine and genetic testing gain momentum and demand increases for tests that can pinpoint early signs of cancer and other diseases.

- read the statement

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