Claim Denials for Cancer-Related Next-Generation Sequencing in Medicare
In this cohort study of cancer-related NGS testing claims among Medicare enrollees, denial rates varied by testing type and testing site and increased over time. The findings suggest the continued existence of uncertainty regarding coverage for NGS, despite the NCD. Policy approaches to further reduce uncertainty regarding NGS coverage and raise awareness of potential financial liability warrant consideration.
Authors
- Carole Roan Gresenz (ORCID: https://orcid.org/0000-0002-7381-7914)
- Ilina C. Odouard (ORCID: https://orcid.org/0009-0006-5431-3979)
- Soyeon Kang (ORCID: https://orcid.org/0000-0003-0049-2490)
Institutions
- Johns Hopkins University (US)
- Georgetown University (US)
Publication Details
- Journal
- JAMA Network Open
- Published
- 2025-04-18
- DOI
- https://doi.org/10.1001/jamanetworkopen.2025.5785
- Citations
- 3
- Primary Topic
- Economic and Financial Impacts of Cancer
- Type
- article
- Field-Weighted Citation Impact
- 9.39
Funders
- Arnold Ventures
- National Institutes of Health
- National Cancer Institute