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Discrepancies in payer coverage and practice guidelines for genetic testing of ACMG cardiovascular genes

Date:
Thursday, Apr 4, 2019 10:00am – 11:30am
Conference:
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Authors:
Nancy Niguidula, Jill Dolinsky, Greg Nogle, Carrie Horton, Tami Johnston, Heather Zimmermann, Benjamin Feldmann, Illa Hadzimehmedagic, Zöe Powis
  • The clinical presentations of many inherited cardiovascular (CV) conditions overlap, thereby genetic testing may clarify diagnoses and facilitate appropriate clinical management.
  • The ACMG published a guideline for 59 genes with clinical actionability that should be reported if found on exome, of which 30 are related to CV conditions.
  • We compared the published practice guidelines for CV genetic testing against the 2018 coverage policies of 4 large US healthcare plans (102 million lives covered) and found that payer coverage is inconsistent and often limited across the CV conditions for the clinically actionable ACMG genes.