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Cancer Genomics Policy in Michigan

Cancer Genomics Policy in Michigan

The goal of the Michigan Cancer Genomics Program is to reduce the incidence and mortality of hereditary cancers, including breast cancer at a young age, ovarian cancer, endometrial cancer, and colorectal cancer. In line with that goal, MDHHS, the Centers for Disease Control and Prevention (CDC) and the Michigan Association of Health Plans (MAHP) are partnering to encourage the development and implementation of written coverage policies for cancer genetic services among Michigan health plans. These policies include genetic counseling, testing, and related clinical genetic services for Hereditary Breast and Ovarian Cancer (HBOC) and Lynch Syndrome (LS).

Under the Affordable Care Act, genetic counseling with consideration of BRCA testing are recommended preventive services for women at increased risk for inherited breast and ovarian cancer. In addition, Healthy People 2020 includes the following Genomics Objectives:

  1. Increase the proportion of women with a family history of breast and/or ovarian cancer who receive genetic counseling
  2. Increase the proportions of newly diagnosed colorectal cancer who receive genetic testing to identify Lynch Syndrome

This page provides an overview of recommended policies for Michigan health plan providers. For specific guidelines and technical support, please call the MDHHS Genetic Information Line at 1-866-852-1247 or email genetics@michigan.gov.

National Recommendations and Guidelines

National science-based recommendations support the use of family health history, cancer risk assessment, genetic counseling, and testing to guide clinical care. These practices are rapidly becoming standards for patients with a personal and/or family history of cancer who are at high risk of having a hereditary syndrome.

The U.S. Preventive Services Task Force (USPSTF) 2013 Recommendations on risk assessment, genetic counseling and genetic testing for BRCA-related cancer in women are two-fold:

  • Women who have family members with breast, ovarian, fallopian tube, or peritoneal cancer should be screened to identify if their cancer history is associated with an increased risk of carrying a BRCA mutation. If there is increased risk of a BRCA mutation, women should receive genetic counseling to determine whether BRCA testing would be useful. Genetic testing should be conducted when indicated.
  • Women whose family history is not associated with increased risk for BRCA mutations should not have routine genetic counseling or BRCA testing.

The Evaluation of Genomic Applications in Practice and Prevention (EGAPP) Working Group recommends that:

  • Genetic testing for Lynch Syndrome be offered to individuals with newly diagnosed colorectal cancer, regardless of the age of diagnosis.
  • If individuals are found to have Lynch syndrome, their family members can benefit from genetic testing to learn if they are also at increased risk of Lynch syndrome-related cancers.

You may also visit the National Comprehensive Cancer Network for additional evidence-based guidelines:

  • NCCN Guidelines for Lynch Syndrome Screening
  • NCCN Guidelines for Breast and/or Ovarian Cancer Genetic Assessment

Michigan Law on Genetic Testing

Michigan law requires health care providers to obtained written, informed consent before pre-symptomatic or predictive genetic testing. Providers are responsible for providing information to their patients about the purpose, risks, benefits and limitations of genetic testing and the appropriate interpretation of test results.

Visit the following for information and resources about informed consent:

Model Health Plans

MDHHS partners with MAHP and the Michigan Cancer Genetics Alliance (MCGA) to identify Michigan health plans that have written policies aligned with cancer genomics best practices. These model health plans are honored at key events in recognition of their exemplary, best-in-class policies.

Checklist for Health Plan Administrators

MDHHS and MAHP have developed the following checklist for health plan staff to describe policies aligned with best practices for genetic counseling, testing and management related to hereditary cancer:

  1. Become familiar with the basics of cancer genetics, HBOC and Lynch Syndrome
  2. Define specific criteria to be used for evaluation of medical appropriateness
  3. Review sample model policies and prior authorization forms
  4. Understand and define key terms and concepts within the policy
  5. Create genetic counseling and testing policies using important policy points
  6. Create or alter clinical services policies to include appropriate management for HBOC and LS patients
  7. Educate and disseminate new policies and forms to providers

State Resources

National Resources

Contact Us

Order cancer genomics resources.

If you have questions, call the MDHHS Genetic Information Line at 1-866-852-1247 or email genetics@michigan.gov. For cancer genetic counseling and testing services in your area, visit the Directory of Clinical Cancer Genetic Services in Michigan.

P.O. Box 30195
333 S. Grand Avenue
Lansing, Michigan  48909-30195

Cancer Genomics Home Page

Funding for this program was made possible (in part) by the Centers for Disease Control and Prevention. The views expressed in written materials, publications, or webpages do not necessarily reflect the official policies of the U.S. Department of Health and Human Services, nor does the mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.

Last updated: 6/23/2022