Blues Plan’s Genomic Test Coverage May Start Trend

In a first-in-the-nation move, Blue Shield of California has agreed to cover rapid and ultra-rapid Whole Genome Sequencing for critically ill infants and children in intensive care who have unexplained medical conditions. The agreement — which will use testing at Rady Children’s Institute for Genomic Medicine, a center of excellence in genetic testing — likely will spur additional insurers to add coverage for this diagnostic technology, observers say.

“I think the way the health plans are going to go about implementing this is exactly what you’re seeing in this case — they’re going to pick a center of excellence,” Ashraf Shehata, KPMG national sector leader for health care and life sciences, tells AIS Health. “I think they’re going to put some bumper guards around how they could go forward with these approvals. And I think in addition to that, you’re going to see their medical policies probably begin to adapt a bit more to accept the outputs that are coming from these types of tests.”

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