Breast Cancer Test Maker Asks Justices to Review Payment Denial

Oct. 22, 2021, 10:12 PM

Clinical laboratory Agendia Inc. is asking the U.S. Supreme Court to review the denial of Medicare reimbursement for two of its breast-cancer diagnostic tests.

The U.S. Court of Appeals for the Ninth Circuit upheld the reimbursement denial, which originated with a private contractor hired by the Department of Health and Human Services to establish coverage policies for diagnostic laboratory services.

Those services included the molecular diagnostic tests developed by Agendia to aid in the diagnosis of breast cancer. The private contractor, Palmetto GBA, a Medicare administrative contractor, approved one of the Agendia tests for reimbursement but not two others during ...

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