Medicare coverage advances for Lumos's FebriDx
US reimbursement coverage now achieved with four of seven Medicare Administration Contractors
Momentum continues with negotiations in process with remaining three
Special Report: Lumos Diagnostics is continuing to advance the US reimbursement pathway for its FebriDx test, a rapid point-of-care diagnostic designed to differentiate between bacterial and non-bacterial acute respiratory infections.
Lumos Diagnostics (ASX:LDX) has announced it has received confirmation of Medicare reimbursement coverage from two additional Medicare Administrative Contractors (MACs), First Coast Service Options (FCSO) and Noridian Healthcare Solutions (Noridian).
The company said FebriDx would be added to the Medicare fee schedules at of FCSO and Noridian, with coverage backdated to April 1, 2025.
FCSO is responsible for managing Medicare payments in the state of Florida. Noridian provides coverage across a wide geographic region that includes California, Nevada, Oregon, Washington, Idaho, Montana, Utah, Arizona, Wyoming, North Dakota, South Dakota, Alaska and Hawaii.
The inclusion of the two MACs adds to coverage from Novitas and Palmetto announced last week.
Lumos said it now had Medicare reimbursement from four of the seven MACs, representing over 55% of the total US Medicare payment coverage.
Pic: Lumos Diagnostics
Set reimbursement rate for FebriDX
Coverage by the MACs follows the Centers for Medicare & Medicaid Services (CMS) including FebriDX in the 2025 Clinical Lab Fee Schedule (CLFS).
Under the CLFS, a proprietary laboratory analyses (PLA) code (0442U) was set for FebriDX to be reimbursed at a rate of US$41.38 per test from January 1.
Lumos said the CMS set PLA code was a pivotal milestone in securing reimbursement for FebriDx from both government and private insurers.
Momentum in its commercialisation efforts significantly expands Lumos' access to the Medicare patient population.
Medicare adoption often sets a precedent for private insurers, paving the way for broader reimbursement acceptance.
The company said reimbursement coverage, particularly from private payors, traditionally followed real-world use.
Addressing antibiotic resistance
FebriDx enables point-of-care differentiation between bacterial and non-bacterial infections – a critical capability given that most acute respiratory infections are viral in nature and do not require antibiotics.
Despite this, antibiotics are still prescribed in up to 50% of these cases, fuelling the growing challenge of antibiotic resistance.
The World Health Organization has warned that the global rise in antibiotic resistance poses a major threat to public health, reducing the effectiveness of commonly used antibiotics against widespread bacterial infections.
Managing director Doug Ward said securing additional Medicare coverage from FCSO and Noridian for FebriDx reinforces its commitment to developing a POC diagnostic solution that benefits patients, but also integrates seamlessly into care pathways and delivers value to the broader health system.
'Lumos remains committed to securing adoption from the remaining three MACs and pursuing reimbursement coverage from private payors, with the goal of achieving nationwide access for patients and supporting broad clinical adoption of FebriDx,' he said.
This article was developed in collaboration with Lumos Diagnostics, a Stockhead advertiser at the time of publishing.
This article does not constitute financial product advice. You should consider obtaining independent advice before making any financial decisions.
Hashtags
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
News.com.au
2 hours ago
- News.com.au
Prime Minister's Anthony Albanese's promise for a ‘stronger, fairer' economy
OPINION This week in Canberra we are bringing together leaders from the business community, the union movement and civil society to work on making the Australian economy stronger, fairer, more productive and more resilient into the future. These discussions will be informed by nearly 900 submissions from experts, industry leaders and individuals and over 40 forums that Ministers have held right around the country. This process has brought forth a wide range of views on everything from deregulation to tax reform. This healthy public debate has also made it clear there is substantial common ground on many issues – and that is where the immediate opportunities lie. Australians understand this is a time of significant global economic uncertainty. Yet for our nation this is also a moment of profound opportunity. Because when you think about the big changes underway in the world: the shift to clean energy, the economic transformation of the Indo-Pacific, the race for new skills and knowledge and the rise of new technologies like AI, there is nowhere else you'd rather be than right here in Australia. With our resources, our skills, our sunlight and space and our proximity to the fastest growing region of the world in human history, we have a powerful combination of national strengths. Making the most of these advantages depends on making sure our economy rewards people for their hard work, invests in their talent and capacity and nourishes their aspiration. That's what this roundtable is about, it's what the agenda we took to the election was all about: a plan defined by Australian values, built on valuing every Australian. This is what people voted for on the May 3 and it is what our Government has spent every day since working to deliver. As promised, our legislation to cut student debt by 20 per cent was the first bill to pass the Parliament. This reform saves 3 million Australians an average of $5,500 and – just as importantly – it makes the repayment system fairer into the future. We've already opened the first of our 50 new Medicare Urgent Care Clinics, adding to the network of 87 we opened in our first term. Taking pressure off public hospitals and making sure people can get the treatment they need, with just their Medicare card. From the 1st of July this year, another round of energy bill relief has rolled out for every household and small businesses around Australia. Paid Parental Leave has been expanded by another two weeks and superannuation has been added to it for the first time ever. Three million workers on the minimum wage and award wages have received another real pay increase. And on the 1st of July next year – and the year after that – all 14 million taxpayers will receive our top-up tax cuts. Because we want Australians to earn more and keep more of what they earn. We are investing in greater economic opportunity for women, abolishing non-compete clauses and pursuing competition reform to boost productivity. Delivery is what drives our Government. We understand that delivery is fundamental to building and repaying people's trust, because delivery is what makes a positive and concrete difference to people's lives. As Prime Minister and as Treasurer, we both see this week's roundtable as a valuable opportunity to help deliver and fulfil the commitments we have made to the people of Australia, as well as expanding our vision to take our nation forward. Delivering on our promise to build more homes means cutting through the red tape that is holding back housing construction, as well as clearing away barriers that stand between skilled workers and key projects. We are committed to making more things here in Australia. This is why we want to get on with fixing the broken approvals process, so households and industry alike can seize the opportunities of cleaner and cheaper energy to bring down their bills and power the next generation of manufacturing jobs. We want to make sure Australian workers and Australian business have the skills and safeguards to get the best out of new technology, including AI. In such a fast moving space we must get the balance right: maximising the productivity benefits while protecting people from potential risks. Ensuring AI is a creator of good jobs, not a threat to them. These are significant challenges but the last three years offer compelling proof that Australia is more than capable of rising to meet them. Together, we have come through the worst global inflation since the 1980s and the biggest international energy crisis since the 1970s. When we came to Government in May 2022, real wages were going backwards, inflation had a 6 in front of it and was rising and interest rates had started going up. Today, real wages are growing at their strongest rate in five years, inflation has a 2 in front of it and interest rates have been cut three times in the last 6 months. At the same time over 1.15 million new jobs have been created. Importantly, the gender pay gap is down to a record low and women's workforce participation is at a record high. This progress is a credit to the hard work of the Australian people and it is a powerful repudiation of those who argued that the only way to bring inflation down was to drive unemployment up and cut services and support for people under pressure. Our responsible approach has brought inflation under control while providing direct assistance with cost of living, keeping employment strong, getting real wages up and delivering the first back to back Budget surpluses in nearly two decades. There is more that can and must be done to drive growth, boost productivity, strengthen the budget and secure our future prosperity. This is not a task for one roundtable or the decisions of one budget. It is a continuous effort: bedding down the changes we have begun, building on the foundations we have laid and delivering further reform in coming weeks, budgets and parliamentary terms. During the campaign, we indicated the Australian economy had turned the corner. This week's roundtable will help us make our way forward, with no-one held back and no-one left behind.
Sydney Morning Herald
14 hours ago
- Sydney Morning Herald
Government must make clear roundtable is only the first step
A month after the election, Anthony Albanese gave a speech to the National Press Club. Eight days later, Jim Chalmers did the same. The two speeches were monologues, of course – but seemed to be in dialogue with each other. Albanese announced a roundtable at which the government would try to build support for economic reform, 'to drive growth, boost productivity, strengthen the budget and secure the resilience of our economy'. Chalmers, speaking of that same roundtable, said – almost as though replying directly to the prime minister – 'No sensible progress can be made on productivity, resilience or budget sustainability without proper consideration of more tax reform.' So if we don't see any tax reform coming directly out of this roundtable – which finally arrives this week – will the rest of us be justified in saying 'no sensible progress' has been made? The short answer is no – but with some important caveats. Why shouldn't the government be ridiculed if it fails to do much on tax this week? The answer lies in timing. Labor has been careful to keep its goals for the roundtable pretty broad. It has talked about building consensus and shaping long-term directions; it wants the event to 'lead to' concrete actions, with ideas generated for the next three budgets. All this can sound a bit of a squib – but there are good political reasons to proceed cautiously. It's highly unlikely most voters are ready for a series of tax announcements. Remember that Labor, early in its first term, foreshadowed tough conversations with voters about precisely these topics: spending and taxing. We need more services, which means we need more tax, which is harder to get with an ageing population. The government knew those conversations needed time. In the end, though, it didn't end up having them, for good reason: inflation made it a pretty stupid time to be asking people to pay more tax. Loading Now the government is having to start that process again. This time, that tax conversation has been reframed, to be about productivity. Productivity has been the government's buzzword since election night. But in political terms, that's no time at all. If anyone at the summit thinks 'productivity' has penetrated the dinner table discussions of most families yet, they're crazy. That's the argument for not acting straightaway. At the other end of the spectrum is the idea Labor will take only big changes – in particular on tax – to the next election. The prime minister has previously spoken of perhaps taking more of his universal childcare agenda to the next election. So you can imagine the government offering, at that poll, a new tax agenda alongside other changes – so that, say, higher taxes were balanced by better or cheaper services, such as childcare. This approach would be consistent with past Labor policies to introduce universal care, such as Medicare and the NDIS, both of which came with levies attached. (The opposition says, 'you don't raise living standards by raising taxes', which sounds like common sense until you remember Medicare did exactly that.)
Sydney Morning Herald
14 hours ago
- Sydney Morning Herald
They built a billion-dollar start-up from their garage. Now they're going again
They created one of Australia's most valuable technology start-ups in a Brisbane garage – Go1 – an education platform most recently valued at $3 billion. Now, Go1 co-founders Vu Tran and Andrew Barnes and entrepreneur Gopi Sara have unveiled their next company, OneMRI, which they say is Australia's first and only national provider of whole-body MRI scans. They say it has a similarly sized growth opportunity to their prior start-up. Existing Go1 investors and executives as well as clinicians and radiologists have poured a collective $2.5 million into OneMRI in a seed funding round to fuel its expansion nationally, amid rising demand from 'health curious' individuals who want a full-body scan but don't know where to turn. In between running start-ups, Tran works as a general practitioner, and he said in an interview that OneMRI had been born out of a frustration in not knowing how or where to refer patients for MRI scans. 'It's not covered by Medicare, and no one is catering for it,' Tran said. 'There are all these machines out there that are underutilised, and there are a lot of people out there who want MRI scans. We're that bridge. 'I've been a GP for 10 years and patients are more interested in wellness and their healthcare than they've ever been. And unfortunately, there's a lot of focus in the Medicare system on sick care, not necessarily health care.' Barnes spent nearly a decade as Go1 CEO before stepping down in August last year, though he still spends some time working at the company and he remains on its board. He started Go1 with Tran, a schoolmate, and Chris Hood in 2015 and that same year they were accepted into the Silicon Valley start-up accelerator Y Combinator. More than 10,000 organisations now use Go1 for staff training, and 50 million registered users have completed courses on the platform. Go1 executives are reported to be mulling an IPO and the company has an ambition to reach 1 billion learners globally.
