Myriad Genetics Says BRCA Testing Receives Designation Under Affordable Care Act

Myriad Genetics, Inc.

announced today that three federal agencies including the U.S. Department of Health and Human Services, the U.S. Department of Labor, and the U.S. Department of the Treasury have issued a set of FAQs clarifying BRCA testing as a preventive service under the provisions of the Affordable Care Act. Importantly, this clarification will allow for BRCA testing to be completed with no patient cost sharing for all non-grandfathered private insurance plans when an asymptomatic woman has a qualifying family history. "We view this clarification as a recognition of the critical value of BRACAnalysis® as a preventive service in women's health," said Pete Meldrum, President and Chief Executive Officer of Myriad Genetics Inc. "This designation goes a long way in ensuring that high-risk women can now have access to the life-saving preventive information provided by BRACAnalysis® without the financial burden of out-of-pocket expenses." On September 17, 2010, a provision of the Affordable Care Act became effective that required non-grandfathered, private, insurance plans to cover items or services with no patient cost sharing that had a rating of "A" or "B" by the United States Preventive Services Task Force. Screening for deleterious mutations in the BRCA1 and BRCA2 genes was incorporated in the guidelines with a rating of "B" but due to some ambiguous language it was unclear to health plans whether the recommendations included only genetic counseling or the actual test itself. This ambiguity has now been clarified to grant BRCA testing as well as genetic counseling a preventive care designation under the Affordable Care Act. In 2012, only 48 percent of Americans receiving their health insurance coverage through their employers were enrolled in grandfathered insurance plans; down from 56 percent in 2011, according to Kaiser Family Foundation Employer Health Benefits Survey. According to the same survey, 19% of health plans in 2012 were high deductible plans, which was up from only 8% in 2009. These plans can lead patients to delay important preventive care given the high out-of-pocket costs for healthcare services until deductibles are met. Going forward, women who are members of non-grandfathered insurance plans, who are determined to be high risk by their healthcare providers, will have no out-of-pocket costs including copays, deductibles, and coinsurance when ordering BRACAnalysis® and BART™ as a preventive service. This clarification will take effect immediately and Myriad looks forward to working with private insurance plans to implement the changes to ensure broader access to patients.