In accordance to Veracyte, Inc. (VCYT), Centers for Medicare and Medicaid Services (CMS) has issued its revised final 2017 Medicare reimbursement rate for the Afirma Gene Expression Classifier (GEC) of the company. The organization has enabled the genomic test's current rate of $3,200 will be maintained in the year of 2017 as a result of Veracyte’s reconsideration appeal or request. This ultimate Medicare reimbursement rate replaces the earlier released lower "gap fill" amount and will go into effect on the day of January 1, 2017.
According to Bonnie Anderson, Veracyte's president and chief executive officer, “We’re happy with the decision of CMS to uphold the Afirma GEC Medicare reimbursement rate that the organization has been paying since the year of 2012. Furthermore, we consider that Medicare reimbursement for the Afirma GEC will now sustain to be stable for the foreseeable future due to the final Medicare rates in place for the year of 2017 and market-based pricing to start in 2018 year through the Protecting Access to Medicare Act”.
The Medicare reimbursement rate declared today follows submission of Veracyte to CMS of a reconsideration appeal expressing its uncertainties that the earlier released lower gap fill rate was not supported by CMS's own gap fill regulatory criteria. The price of a test is verified by the median price submitted by each of CMS's Medicare Administrative Contractors (MACs) of CMS through the gap fill procedure.
Through the Protecting Access to Medicare Act (PAMA), starting on the day of January 1, 2018, Medicare reimbursement for advanced genomic tests will be certainly deployed on the median price paid by commercial payers, which Veracyte calculates and measures as above $3,200 for the Afirma GEC. The latest market-based Medicare rate will override any previous rate under the PAMA. Almost 20 percent of Afirma GEC test volume is represented by Medicare.