Agendia Again Loses Bid for Breast Cancer Test Medicare Payment

A federal judge upheld the US government’s denial of Medicare coverage for breast cancer tests made by a California-based diagnostic laboratory that claimed it was arbitrarily denied by Medicare contractors.

In an opinion issued March 29, Judge John D. Bates of the US District Court for the District of Columbia upheld five administrative decisions by Centers for Medicare and Medicaid Services denying reimbursement to Agendia Inc. for its breast cancer tests. The decisions applied to a policy requiring “substantial deference” be given to coverage determinations issued by private Medicare ...