Exact Sciences (EXAS) Announces Expansion of Cologuard Coverage with Florida Blue, HCSC
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Exact Sciences Corp. (Nasdaq: EXAS) announced that Health Care Service Corp. (HCSC), the nation's fourth largest health insurer, and Florida Blue recently updated their medical policies to cover Cologuard. With these policy updates, 80 million people are insured by commercial plans with positive medical policies regarding Cologuard. Including Medicare, Cologuard is now covered for 62 percent of its total target population.
"We are pleased that Cologuard's commercial coverage continues to broaden following its inclusion in the recently-updated U.S. Preventive Services Task Force colorectal cancer screening recommendations," said Kevin Conroy, chairman and CEO of Exact Sciences. "As health plans continue to update their coverage policies to include Cologuard, an increasing number of people have access to an innovative, non-invasive colorectal cancer screening option."
HCSC is the largest customer-owned insurer in the United States. Its subsidiaries include Blue Cross and Blue Shield plans in Illinois, Texas, Montana, New Mexico and Oklahoma. Under HCSC's updated policy, which is effective Aug. 15, 2016, Cologuard may be considered medically necessary for colorectal cancer screening once every three years for average risk patients who are not up to date with screening. The HCSC policy update states, "In 2016, the USPSTF updated their CRC screening guidelines to recommend the use of gFOBT, FIT, FIT-DNA (multitargeted stool DNA testing), colonoscopy, CT colonography, and flexible sigmoidoscopy for individuals ages 50 years to 75 years at average risk of colorectal cancer." To read HCSC's policy, click here.
According to Florida Blue's updated policy, "The use of an FDA approved fecal DNA test (e.g. Cologuard) meets the definition of medical necessity once every three years as a screening technique for members in whom colorectal cancer preventive screening is indicated (per USPSTF Colorectal Cancer Screening Grade A recommendation)." To read Florida Blue's policy, click here.
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