Medicare May Cut Breast Cancer Test Coverage for 35 Million Women
Updated
Updated · theSkimm · Jul 6
Medicare May Cut Breast Cancer Test Coverage for 35 Million Women
1 articles · Updated · theSkimm · Jul 6
Summary
A Medicare-commissioned committee recommended ending coverage for a routine breast cancer biomarker test that helps gauge tumor aggressiveness, recurrence risk and whether chemotherapy is needed.
The panel—created by a Blue Cross Blue Shield subsidiary and including no cancer specialists—said evidence backing the test was flawed, a conclusion oncologists dispute with peer-reviewed studies.
One study found the test showed chemotherapy was unnecessary in 70% of cases, raising fears that losing coverage would push more patients into avoidable, costly and physically taxing treatment.
Private insurers often follow Medicare’s lead, so doctors warn a final cutoff could ripple beyond women 65 and older as breast cancer cases rise among younger women.