With the genetic testing business booming, national health insurer Cigna Corp. is telling its customers to get insurer-approved counseling before it will pay for certain tests, a move that has critics questioning the insurer's motives.
"If the counseling is used as a tool to help consumers better direct their care, it will add tremendous value to empower patients," Joshua Archambault, the Pioneer Institute's Director of Health Care Policy, told the Herald about Cigna's new rule.
Starting Sept. 16, Cigna customers who want their insurer to pay for tests that will tell if they are at risk of breast, ovarian and colorectal cancers, or the heart condition Long QT, must first meet with a Cigna- approved counselor.
"If the counseling is solely utilized as a cost-containment measure, patients are likely to be unhappy as the future of medicine will involve individualized care based on one's genetic makeup," Archambault warned.
Cigna says it adopted the policy because these tests, which can cost up to $4,000 each, are often requested and often misunderstood.
The tests "have a lot of implications for patients and their families, and they are hard to understand. It's a new field," said David Finley, Cigna's national medical officer for enterprise affordability and policy.
Dr. Aubrey Milunsky, founder of the Center for Human Genetics in Cambridge, said it's always smart to get counseling before a genetic test.
But Milunsky recommends people who may be at risk for devastating diseases sit down with a medical doctor who specializes in genetics because the evolving field is so complex.
"People are finally beginning to realize the power of DNA, and how precise a test it is," he said.
As a result, he's troubled that Cigna wants its customers to either meet with a pre-selected counselor or speak by telephone with someone from InformedDNA, a private Florida firm.
"In our business, telephone counseling is a no-no," Milunsky said.
Herald wire services contributed to this story.
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