Guam
This data is meant to be used for educational purposes to inform providers, patients, insurers, and state Medicaid agencies what genetic services may or may not be written into each state’s Medicaid policy. The database is not meant to indicate or imply whether a certain program will cover a specific service, since many decisions are made on a case by case basis. If you have specific questions about whether a service is covered, you should reach out to your plan administrator. Please see this disclaimer below for more information.
Medicaid Coverage Information Published
State Contact Information
Carlos Pangelinan
Interim Administrator
Bureau of Health Care Financing Administration-Medicaid Program
Guam Department of Public Health and Social Services
123 Chalan Kareta
Mangilao, GU 96913-6304
Phone: (671) 735-7293
https://medicaiddirectors.org/wp-content/uploads/2023/06/Public_DirectorsList_June2023-1.pdf
General Genetic Testing Criteria
Genetic Testing Not Covered
State Specific Definition
Genetic Services for Children
Genetic Counseling Requirement
Metabolic Formula Coverage Legislation
Metabolic Formula Coverage & Criteria
Prior Authorization Requirements
Prior Authorization Forms
Fee Schedule
BRCA Testing Coverage
Requirements for BRCA
Cystic Fibrosis Screening
Hereditary Cancer Testing Coverage
Lynch Syndrome Testing Coverage
Microarray Testing
Newborn Screening
Guam has approximately 4,000 births per year. Over 90% of these occur at Guam Memorial Hospital. The remainder of the births occur at the Naval Hospital, at Sagua Mañagu (Guam’s first private birthing center), or at home with the aid of midwives. Guam Memorial Hospital, the Naval Hospital, and Sagua Mañagu all have contracts with different laboratories to provide newborn screening. The result is that a different panel of tests is offered to newborns, depending on where they are delivered. Guam Memorial Hospital currently contracts with the Colorado Department of Public Health and Environment. Currently, only newborns with health insurance receive newborn screening. The Guam Department of Public Health and Social Services tracks and follows abnormal results from Guam Memorial Hospital.
Panel Testing
Pharmacogenetic Testing
Prenatal Testing Offered
Whole Exome Sequencing
Other Tests Covered
Other Information
Unlike the 50 states and the District of Columbia, where the federal government will match all Medicaid expenditures at the appropriate federal matching assistance percentage (FMAP) rate for that state, in Guam, the FMAP is applied until the Medicaid ceiling funds and any other specified federal funds are exhausted. The statutory FMAP rate increased to 55% effective July 1, 2011. Starting in January 2014 Congress has temporarily increased the FMAP along with federal funding, bringing Guam’s FMAP to 83% for federal fiscal year 2021.
Resources
Newborn Screening Reimbursement
On this Page
Disclaimer: The information contained in the database has been obtained from sources believed to be reliable but NCC has not attempted to validate or confirm the information. The database may be updated periodically. However, the accuracy and completeness of the information contained in the database cannot be, and is not, guaranteed. NCC makes no warranty of the accuracy, completeness or timeliness of this information, and shall not be liable for any decision made in reliance on this information. It is the user’s responsibility to verify this information by contacting the state Medicaid agency directly.
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