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The Obama administration is facing growing calls to allow Medicare and Medicaid to pay for advanced gene-sequencing of tumors, a step proponents say will help both cancer patients and scientific research.
The appeals have grown louder since Vice President Joe Biden announced his “moonshot” to cure cancer, and top researchers said they raised the issue in a private meeting recently with Biden’s staff. The issue also came up during the vice president’s trip to the World Economic Forum in Davos, Switzerland.
So-called next-generation sequencing can be used to analyze tumors in a more comprehensive way and more quickly than with previous methods. The sequencing allows doctors to determine whether emerging treatments are likely to work for a particular patient — part of a movement toward so-called personalized medicine.
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But the Centers for Medicare and Medicare Services generally does not pay for comprehensive genome-sequencing. Instead, CMS and some private contractors that administer Medicare plans make payments for limited sequencing of tumors for a limited number of conditions.
“We have this weird juxtaposition with the White House and the vice president loving personalized medicine,” said Amy Miller, executive vice president of the Personalized Medicine Coalition. “And CMS often does not pay for it.”
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