Objective: The Michigan Department of Community Health (MDCH) Cancer Genomics Program sought to increase the number of health plans with a written policy aligned with the United States Preventive Services Task Force (USPSTF) Grade B Recommendation stating that women whose family history is associated with an increased risk for deleterious mutations in BRCA1 or BRCA2 be referred for genetic counseling and evaluation for BRCA testing. Methods: Through a cooperative agreement with the Centers for Disease Control and Prevention, MDCH with health plan partners utilized multiple methods (i.e. surveillance, education, federal and state policies, partnerships, and dissemination) to increase the number of health plans with a written policy aligned with the USPSTF Grade B BRCA Recommendation between 2008 and 2011. Results: Since 2008, the number of health plans that have policies consistent with USPSTF Grade B BRCA Recommendation in Michigan increased from 4 to 11. These 11 health plans provide coverage to over 7 million Michigan residents. Honors were bestowed by MDCH to these 11 health plans for their exemplary written policies. Conclusions: MDCH has implemented a novel and effective approach to promote cancer genomics best practices through health plan policies that serves as a model for federal and state agencies.

U.S. Preventive Services Task Force: Genetic risk assessment and BRCA mutation testing for breast and ovarian cancer susceptibility: recommendation statement. Ann Intern Med 2005;143:355–361.
Institute of Medicine of the National Academies: The Future of Public Health. National Academy of Sciences, 1998.
Association of State and Territorial Health Officials: Framework for public health genetics policies and practices in state and local public health agencies. 2001.
Genetic Information Nondiscrimination Act of 2008: H.R. 493, 110th Cong. Washington, 2007–2008.
Patient Protection and Affordable Care Act of 2010: Public Law 111–148, 111th Cong., 2d session, 2010.
Myers E, Havrilesky L, Kulasingam S, Sanders G, Cline K, Gray R, Berchuck A, McCrory D: Genomic Tests for Ovarian Cancer Detection and Management. Evidence Report/Technology Assessment No.145. AHRQ Publication No. 07-E001. Rockville, 2006.
Myriad Genetics, Inc. http://www.BRACnow.com/faqs/#20.
Centers for Medicare and Medicaid Services Local Coverage Determination for Genetic Testing (L24308) 2011. http://www.cms.gov/medicare-coverage-database/details/lcd-details.aspx?LCDId=24308&ContrId=&ver=36.
Comprehensive Cancer Control Plan for Michigan 2009–2015. http://www.michigancancer.org/CancerPlan/ComprehensiveCancerControlPlan-2009-2015.cfm.
Latchaw M, Ormond K, Smith M, Richardson J, Wicklund C: Health insurance coverage of genetic services in Illinois. Genet Med 2010;12:525–528.
The US Census Bureau: Current Population Survey (CPS) 2009. Table H105, Health Insurance Coverage Status and Type of Coverage by State and Age for All People. http://www.census.gov/hhes/www/cpstables/032010/health/h05_000.htm.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.