Exact Sciences is suing another insurer in federal court for its refusal to pay for the company’s colon cancer test.
This time, the Madison biotech company is suing Blue Cross and Blue Shield of North Carolina for refusing to pay at least $410,000 in claims. It’s similar to an earlier suit against Humana, one of the nation’s largest insurers.
Exact Sciences’ Cologuard test analyzes stool samples for abnormal cells that signal colon cancer. It has FDA approval and is covered by Medicare, but the company is working on getting coverage from more commercial insurers.
The lawsuits argue the two insurers should pay for the Cologuard test because it is not “experimental or investigational.” Analysts have said such lawsuits are a somewhat risky move, as Exact Sciences is trying to sign contracts with insurers.
— By Polo Rocha,