The American College of Obstetricians and Gynecologists The American Congress of Obstetricians and Gynecologists 409 12th Street, SW, PO Box 96920 • Washington, DC 20090-6920 • Telephone 202-638-5577 Ordering of Genetic Tests Position Statement The American College of Obstetricians and Gynecologists and The American Congress of Obstetricians and Gynecologists Recent proposals, including several by health care insurers and one by the Centers for Medicare and Medicaid Services (CMS), suggest that genetic counseling must be provided by an individual “certified” in genetic counseling before genetic testing could be ordered. The American College of Obstetricians and Gynecologists and the American Congress of Obstetricians and Gynecologists (ACOG) firmly opposes these restrictions because they impose unnecessary barriers to timely care. Moreover, ACOG opposes such attempts to restrict the scope of practice of obstetrician-gynecologists, who are fully qualified to provide pre-test counseling to their patients. As described in the College Statement of Policy, Certification and Procedural Credentialing, reaffirmed in 2015, graduate medical education in obstetrics and gynecology, certification by the American Board of Obstetrics and Gynecology, and maintenance of certification, is “validation of the medical, surgical, imaging, and laboratory knowledge and patient care skills relevant to the practice of the specialty.” Included in this experience and certification, particularly related to the laboratory knowledge component, is genetic testing. This position is aligned with the American Medical Association Policy H-460.902, “Opposition to Genetic Testing Restrictions Based on Specialty,” which specifically opposes limiting the ordering of genetic testing based solely on physician specialty or other non-medical criteria, and also opposes requirements for utilization of non-affiliated medical specialists or non-physicians prior to ordering genetic testing. We are deeply concerned that these initiatives will prevent women from getting the care they need. With relatively few genetic counselors in the U.S., a requirement for all persons for which genetic testing is indicated to undergo pre-testing counseling by a “genetics professional” would markedly limit access to needed testing. This may be especially true in non-urban areas. A requirement for pre-testing counseling in an area in which “genetics professionals” are not available will potentially leave our patients with nowhere to go and without timely access to care. In conclusion, ACOG reaffirms its position that obstetrician-gynecologists are fully trained and qualified to counsel patients regarding genetic issues specific to pregnancy and women’s health-associated cancers, and that the ordering of genetic testing should not be restricted by a requirement for pre-testing genetic counseling by a separate provider. This requirement would jeopardize our patients’ access to timely care. Approved by the Executive Board: November 2015

American Congress of Obstetricians and Gynecologists
409 12th Street SW, Washington, DC  20024-2188 | Mailing Address: PO Box 70620, Washington, DC 20024-9998