New Laws: Proposed Federal Legislation Would Allow Medicare Payment for Genetic Counselling

A new bill introduced in the U.S. House of Representatives in October calls for CMS to recognize certified genetic counselors as healthcare providers. Here's a quick overview of the bill and why it matters.

What Does It Do?
Under current Medicare rules, genetic counseling is a covered benefit but genetic counsellors can't be reimbursed for providing such services. As a result, Medicare beneficiaries have limited access to counselling. H.R. 7803: Access to Genetic Counselor Services Act of 2018 is designed to fix that problem by allowing genetic counselors to receive payment for services.

Why Now?
The proposed legislation, developed in collaboration with the National Society of Genetic Counselors (NSGC), comes at a time when consumer interest in and access to genetic testing continues to grow and genetic testing plays a greater role in medical care.

What Are Genetic Counselors?
Genetic counselors are key providers of services to consumers. According to NSGC, certified genetic counselors "bring expertise to the healthcare team by guiding and supporting patients seeking more information about how inherited diseases and conditions might affect them or their families, and to interpret test results." 

The bill defines "genetic counselor" as "licensed as a genetic counselor by the state in which the individual furnishes genetic counseling services or in the case of an individual practicing in a state that does not license genetic counselors, meets such other criteria as the [HHS] Secretary establishes."

What's the Impact?
According to NSGC, passage of the bill would improve the overall health system. "Lack of access [to genetic counselors] can result in harm such as incorrect interpretations of genetic rest results, failure to identify individuals' genetic risk, and inaccurate risk assessment leading to inappropriate medical management and sometimes death." 

In addition, NSGC cites financial benefits, indicating that the legislation "will also help lower healthcare costs by shifting genetic counseling services sometimes administered by physicians and nurse practitioners to genetic counseling experts, who can ensure the appropriate use of genetic testing." 

So, stay tuned and NIR will keep you apprised on the bill's progress.