Would you like to advocate for insurance coverage of
cell-free DNA screening for fetal
aneuploidies for ALL of your patients?
As a medical practitioner in [NAME OF STATE], I order cell-free DNA (cfDNA)-based noninvasive prenatal screening (NIPS) for my pregnant patients, as these tests are part of essential prenatal care services. I applaud [NAME OF PLAN] for covering cfDNA-based NIPS for its high-risk patients to detect a range of fetal chromosomal abnormalities from a simple maternal blood sample. However, there is compelling clinical evidence that NIPS is a medically-appropriate screening procedure for all pregnant women who choose to pursue aneuploidy screening—regardless of their risk factors, income, age, or geographic location.
CfDNA-based NIPS has extremely low false negative rates for the common aneuploidies, resulting in high negative predictive values (NPVs) that approach 100%. Additionally, the markedly lower false positive rates of cfDNA-based NIPS provide significantly improved positive predictive values (PPVs) compared to traditional screening tests; this means that the number of unnecessary invasive confirmatory procedures triggered by positive screening results is much lower for NIPS compared to traditional methods.
Commercial health plans representing more than 100 million lives in the United States have already updated their medical policies to cover NIPS for all pregnancies, regardless of risk. I hope you will consider the information provided here and update your medical policy to provide access to NIPS as a medically appropriate option for all of your pregnant enrollees.
[NAME OF SENDER]
[TITLE / ORGANIZATION]