Biotech Values

[DewDiligence]

EXAS +4% on possibility of small reimbursement increase by Medicare (but it may be an error):

http://finance.yahoo.com/news/exact-sciences-addresses-cms-2016-110000967.html

On November 25, 2015, the Centers for Medicare and Medicaid Services (CMS) posted the 2016 Clinical Diagnostic Laboratory Fee Schedule (CLFS) on its website. The reimbursement national limitation amount (NLA) for Cologuard within the 2016 CLFS appears to be inconsistent with what CMS publicly communicated on November 17, 2015, when issuing a final reimbursement decision for Cologuard using the crosswalk methodology to CPT codes 81315, 81275, and 82274. Based on the 2016 CLFS as posted, the sum of the NLAs for those three codes is $501.26.

Last year, the NLA for Cologuard in the 2015 CLFS, as initially posted on the CMS website, was significantly lower than the sum of the NLAs for the three codes to which Cologuard is cross-walked. CMS subsequently issued a correction to the 2015 CLFS and ultimately established an NLA for Cologuard of $492.72.

Exact Sciences requested that CMS clarify the 2016 reimbursement rate for Cologuard. Exact Sciences will communicate more information as it becomes available.