An influential not-for-profit group has issued a draft framework for how next-generation sequencing tests for oncology care should be reimbursed by payers. The report from The Center for Medical Technology Policy (CMTP) comes at a time when anxiety regarding the rates of reimbursement for molecular-based tests has been running high. Many of the regional fiscal intermediaries for Medicare have lagged in providing guidance on payment, prompting many commercial insurers to not cover many tests themselves, or offer payments at rates far lower than what the laboratories consider reasonable. And intermediary Palmetto GBA’s efforts to create standardized codes for such tests through its MolDX system has also caused the laboratory sector additional anxiety. Meanwhile, many labs have been releasing and touting tests and platforms that rely on next-generation sequencing. At the same time, the report suggested that labs may not be in the ideal position to advocate for their own products. "At issue is a growing flood of new genomic variants in need of study and a lack of economic and commercial incentives for testing companies and laboratories to perform the kinds of studies payers and health technology assessment groups generally expect to see," the report noted. "NGS testing methods are…
