Conflicting reports have emerged regarding whether Medicare will cover an ultrasensitive minimal residual disease (MRD) breast-cancer test developed by Personalis Inc. [1, 2, 3].

Access to advanced diagnostic testing can determine the course of cancer treatment and patient outcomes. The resolution of this coverage dispute will decide if thousands of patients can access the test through federal insurance.

Some reports indicate that the U.S. Centers for Medicare & Medicaid Services (CMS) is expanding coverage for the Personalis test [3]. These reports suggest the agency is broadening access to increase the availability of advanced cancer testing for patients [3].

However, other reporting suggests a different outcome. NBC News said Medicare denied the test [1]. According to that report, a company contracted by Medicare recommended that the government not cover the test at all [1].

This discrepancy highlights a potential conflict in the decision-making process. The NBC report said the recommendation to deny coverage may involve a conflict of interest regarding the contracted company [1].

Personalis has previously announced that Medicare would provide coverage for the ultrasensitive MRD test in breast cancer [2]. The test is designed to detect minimal residual disease, which helps clinicians identify if cancer remains in the body after primary treatment.

CMS has not provided a definitive public reconciliation of these contradictory claims. The tension remains between the reported expansion of access and the reported recommendation for total denial [1, 3].

“Medicare’s coverage decision for an ultrasensitive minimal residual disease breast‑cancer test is under dispute.”

This conflict reflects the complex intersection of private diagnostic innovation and federal reimbursement policy. When CMS relies on third-party contractors to determine the clinical utility of a test, any perceived conflict of interest can undermine public trust in healthcare access. The outcome will likely serve as a precedent for how other ultrasensitive MRD tests are evaluated for Medicare coverage.