Prostate cancer test granted draft Medicare LCD

Palmetto GBA, a Medicare Administrative Contractor that assesses molecular diagnostic technologies, has issued a draft local coverage determination (LCD) for the Prolaris prostate cancer test, Myriad Genetics, Inc. announced.

The LCD, which is posted to the Medicare Coverage Database on the Centers for Medicare & Medicaid Services website, establishes the coverage policy for Medicare beneficiaries. The current language in the draft LCD provides reimbursement coverage for the approximately 50% of prostate cancer patients defined as low and very low risk.

Under Medicare rules, the draft LCD is subject to a minimum 45-day public comment period.  After comments are considered, a final LCD is issued, which goes into effect after a minimum 45-day notification period.

"We are very excited by this draft coverage determination as a first step in ensuring that all Medicare prostate cancer patients will have access to Prolaris testing which we believe provides the highest quality and most accurate assessment of their cancer's aggressiveness," said Pete Meldrum of Myriad. "In multiple clinical validation studies, Prolaris has been shown to be a much stronger indicator of clinical outcomes than adverse pathology for patients across all risk categories."

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