CMS panel backs current Cologuard reimbursement rate
Exact Sciences Corp. (NASDAQ:EXAS) said CMS's Advisory Panel on Clinical Diagnostic Laboratory Tests voted 11-0, with one abstention, to maintain Medicare's reimbursement rate for Cologuard in 2016 at $492.72 per test.
During a CMS meeting last month to discuss 2016 payment levels for clinical tests, Exact Sciences Chairman and CEO Kevin Conroy proposed that Cologuard reimbursement be continued at $492.72 based on a current procedural terminology (CPT) code created by the American Medical Association (AMA). Jacob Ma-Weaver, portfolio manager of hedge fund Cable Car Capital, had proposed a reduced reimbursement rate for the non-invasive DNA screening test for colorectal cancer. Cable Car holds a short position in Exact Sciences (see BioCentury Extra, July 16). ...