Updates in 2014: BRCA Testing and the Affordable Care Act

The U.S. Preventive Services Task Force released its recommendations at the end of December regarding genetic testing for BRCA mutations. The recommendations provide a much needed framework to healthcare providers and insurance companies for determining which patients should receive genetic testing (and insurance coverage) for potential BRCA gene mutations.

The task force concluded that genetic counseling and genetic testing for BRCA-related cancer are beneficial for a small percentage of women who are considered high-risk according to their family histories (approximately 10% of the general American female population). Women who have had family members with breast, ovarian, tubal, or peritoneal cancer should speak with their healthcare provider about a potential increased risk of carrying a BRCA mutation. Women who are screened positive for this risk based on their histories should then receive genetic counseling, and then, only if indicated after counseling, BRCA testing.

The final recommendation means that under the Affordable Care Act, insurers must cover these screening services with no cost-sharing for women considered to be high-risk. It would exclude coverage for the 90% of American women who are not considered high-risk based on their family histories.

As our understanding of genetics and their role in our health continues to grow, accurate and thorough family histories are more important—and necessary—than ever. For more information and practice tools for family histories, visit these websites:

www.myriadpro.com
https://www.breastsurgeons.org/statements/PDF_Statements/BRCA_Testing.pdf
www.nccn.org/professionals/physician_gls/f_guidelines.asp

For the entire task force recommendations on BRCA testing, please click here.

REFERENCES

http://news.nurse.com/article/20140101/NATIONAL06/131230004#.UsVnXrSIkTI
http://www.uspreventiveservicestaskforce.org/uspstf12/brcatest/brcatestfinalrs.htm