NEW YORK (GenomeWeb) – MDxHealth announced today that the Health Care Services Corporation (HCSC) has issued a positive coverage decision for the ConfirmMDx for Prostate Cancer test.
HCSC — which MDxHealth said is the fourth-largest insurer in the US — operates Blue Cross and Blue Shield plans in Illinois, Montana, New Mexico, Oklahoma, and Texas. It covers more than 15 million customers.
"This is the third Blue Cross Blue Shield Association licensee to establish a positive coverage policy and adds five more BCBS plans to the growing list of payers covering ConfirmMDx for Prostate Cancer," said MDxHealth CEO Jan Groen in a statement. "We believe HCSC's decision is a significant step in providing national access to ConfirmMDx for Prostate Cancer, further expanding the impact on patient outcomes and reduction in cost to the US healthcare system."
In March, the test was included in the US 2016 National Comprehensive Cancer Network (NCCN) Guidelines for prostate cancer screening. "Tests that improve specificity in the post-biopsy state — including 4Kscore, PHI, percent free PSA, PCA3, and ConfirmMDx — should be considered in patients thought to be higher risk despite a negative prostate biopsy," according to the NCCN guidelines.
ConfirmMDx is an epigenetic tissue-based test for the early detection of prostate cancer, specifically aimed at addressing false-negative biopsy concerns. It has qualified for Medicare, Medicare Advantage, and other private reimbursement plans.
MDxHealth has also received positive coverage decisions for the test from several other insurers in recent months, including the California Medical Assistance Program and Independence Blue Cross in September, and Highmark BCBS earlier this month.