Cigna Corp. will require its customers to get "genetic counseling" before the health insurer pays for extensive testing to determine if a customer has genes associated with breast cancer, ovarian cancer, colorectal cancer or a heart condition called Long QT syndrome.

The Bloomfield company is the first major health insurer to adopt such a policy. The change takes effect Sept. 16.

The new policy reflects a shift in thinking among medical societies and cancer groups who now believe that far more people are getting tested than those who are at risk of having genes associated various cancers or Long QT syndrome.

In medicine, there's a wide variety of genetics testing, and Cigna will continue to pay for many tests, said David Finley, national medical officer for enterprise affordability and policy at Cigna Corp. Some tests are applicable for some patients and not others.

Cigna decided to manage genetic tests for breast cancer, ovarian cancer, colorectal cancer and Long QT syndrome because the tests are commonly requested and frequently misunderstood, Finley said.

In the current system, a patient tells her doctor that she is interested in getting genetic testing to see if she has a gene associated with breast cancer. The doctor then sends in some of the patient's personal medical history to Cigna, and the insurer makes a determination "yes" or "no" about the genetic testing. The insurer would inform the patient of her appeal rights, if the testing is declined.

"That standard way of doing it, we did not feel met the needs of our customers because it didn't help to educate them, and this is a very complicated test, which a lot of people meaning doctors and patients don't fully understand," Finley said.

Finley said there's an increasing consensus among doctors that genetic counseling should be a part of genetic testing. For one thing, board-certified genetic counselors, on average, are better informed about genetics tests than doctors especially as the field of study grows rapidly, Finley said.

The tests, Finley said, "are coming at a fast and furious rate."

"They have a lot of implications for patients and their families and they are hard to understand. It's a new field," he said.

Link:
Cigna To Require Counseling Before Extensive Genetic Tests For Cancer

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