Health Care Service Corporation (HCSC), the 5th largest private insurance payer in the US, will implement a positive coverage policy for Fractional exhaled Nitric Oxide (FeNO) testing for the diagnosis and management of asthma effective April 1, 2014, according to a press announcement by Aerocrine, whose NIOX MINO device is the only FeNO device cleared by the FDA and commercially available in the United States.
FeNO testing is a two-minute point-of-care breath test that can be used to identify patients with allergic airway inflammation. Airway inflammation is widely recognized as the underlying cause of asthma. Using routine FeNO testing to guide therapy, particularly inhaled corticosteroid therapy, for asthma patients has been shown to reduce asthma exacerbations up to 50 percent, according to Aerocrine.
HCSC provides insurance coverage for 14 million individuals and its subsidiaries include Blue Cross and Blue Shield plans of Illinois, Montana, New Mexico, Oklahoma, and Texas.
The new HCSC policy is a positive coverage policy that states FeNO testing may be considered medically necessary for the diagnosis and treatment of asthma. This change in policy now allows reimbursement of claims based on medical necessity.
Currently, seven of the US’s top 12 insurers provide coverage and reimbursement for this test, according to Aerocrine. NIOX MINO is now reimbursed by the three largest Blue Cross and Blue Shield companies in the United States, plans that account for over 40 million covered lives. In all, 64% of US insured lives now have access to Aerocrine’s test nationwide, according to the company.
“This is a very positive change that we hope will encourage other payers to review their FeNO coverage policies and provide coverage,” said Scott Myers, CEO, Aerocrine AB. “We believe this change at HCSC will demonstrate to physicians that insurers support FeNO testing to improve clinical decision making, patient and health economic outcomes for asthma management.”
For more information regarding the change in the HCSC policy is available in the “pending medical policies” section of its website.