UHC Fine-tunes Policy on Genetic Counseling Prior to BRCA Test
February 25, 2016A recent policy change by UnitedHealthcare (UHC) clarifies who can provide genetic counseling before its members undergo a BRCA test. The decision prompted pushback from the American College of Obstetricians and Gynecologists and the American Congress of Obstetricians and Gynecologists, known collectively as ACOG. Among UHC members, as of Jan. 1, “genetic counselors or physicians must provide a brief counseling with the patient and certify the need for the genetic testing prior to the BRCA test being performed,” according to spokesperson Lynne High. For several years, UHC — as well as other insurers — has required prior authorization for BRCA testing, she points out. The difference now, though, is that previously, “the laboratories administering the genetic tests have been able to provide this certification,” which will now not be permitted, High tells SPN. “It is our belief that patients deserve a more thorough evaluation from a qualified health care professional.” In mid-December, ACOG released a position statement opposing requirements “that genetic counseling must be provided by an individual ‘certified’ in genetic counseling before genetic testing could be ordered…because they impose unnecessary barriers to timely care. Moreover, ACOG opposes such attempts to restrict the scope of practice of obstetrician-gynecologists, who are fully qualified to provide pre-test counseling to their patients.”