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ECS Become The Standard

There are many opportunities to support coverage for ECS. Below are a few options with resources on how to get started.

You are invited to participate in one of our informational webinars.

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What Everyone Needs to Know Before Starting or Adding to Their Family

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Write your state Medicaid program to request they cover ECS so that everyone has access to this important diagnostic tool.

Medical Providers Talking Points:

 Introduction

  1. Introduce yourself and your job/position.
  2. State your support of coverage for expanded carrier screening

Provide Background on Expanded Carrier Screening

  1. ECS is a test that analyzes parents’ (both male and female) DNA to see if they are a carriers of a genetic variant that could cause an inherited disease in their child.
  2. With recent technological advances expanded carrier screening can simultaneously test for multiple serious genetic disorders for all individuals, no matter their background.
  3. The most recent medical guidance from ACOG recognizes ECS as an acceptable screening for pregnancy and prenatal screening.[1]

 Explain How Medical Providers Use Expanded Carrier Screening

  1. Traditionally clinicians have ordered genetic tests based on ethnicity, including Tay-Sachs and cystic fibrosis tests and data has shown that these targeted screenings create inequities in care as they miss a significant proportion of carriers in a diverse patient population
  2. Pan-ethnic ECS panels have become increasingly important for clinicians to support individuals and couples, particularly as it becomes more challenging for individuals to identify their family history as families and societies grow more diverse. Self-reported ethnicity does not accurately reflect a patient’s true ancestry.

Address the Importance of Medicaid Coverage for Expanded Carrier Screening

  1. Ethnicity-based carrier screening misses affected pregnancies, particularly those of non-Caucasian descent. This is important for Medicaid as communities, families and societies grow more diverse.
  2. In my practice I have seen many individuals who would be candidates for expanded carrier screening but have not had access to the service due to the lack of Medicaid coverage.

 Explain How You Use Expanded Carrier Screening

  1. Share how you use expanded carrier screening in your practice and why it is important from your clinical experience. It can be helpful to share a specific patient story or impact on your practice.

 Submit Your Ask

  1. Ask that the [state] Medicaid cover expanded carrier screening through CPT code 81443.

Patient and Advocates Talking Points:

Tell Your Story

  1. Introduce yourself and where you live (in particular if you are based in the state you are writing too).
  2. Introduce you or your families experience with a genetic condition, and how expanded carrier screening could have helped you, or did help you and your family.

Address the Importance of Expanded Carrier Screening and Insurance Coverage in Your Life

  1. Explain how the knowledge produced from ECS has helped (or would have helped) you plan for future children or helped you with getting the resources needed to best support your child’s (or relative’s) future.
  2. Identify how important the knowledge of your carrier risk was or could have been.
  3. Address the importance that insurance coverage for ECS had on your ability to cover ECS.

Ask/Conclusion

  1. Ask that the [state] Medicaid cover expanded carrier screening through CPT code 81443.

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