PEB - Pacific Edge Ltd

[Brain]

Another key difference between PEB and Plexure is that we know that PEB will be selling tests for $1000 NZ for a laboratory cost of $100 whereas we have no idea whatsoever about Plexures margin.

Disclosure hold both but heavily weighted towards PEB

[Greekwatchdog]

Investor update http://nzx-prod-s7fsd7f98s.s3-websit...884/344438.pdf

[850man]

Investor update http://nzx-prod-s7fsd7f98s.s3-websit...884/344438.pdf

especially pleasing to see in there "Since we achieved LCD coverage for CXBladder Detect and CXbladder Monitor from 1 July 2020 we have received close to 100% payment for CMS patient claims, within 35 to 40 days"

[calledone]

Investor update http://nzx-prod-s7fsd7f98s.s3-websit...884/344438.pdf

Nothing new in this that we didn’t know. Was hoping to see some numbers but I suppose they don’t give that out in newsletter.

[Leftfield]

especially pleasing to see in there "Since we achieved LCD coverage for CXBladder Detect and CXbladder Monitor from 1 July 2020 we have received close to 100% payment for CMS patient claims, within 35 to 40 days"

No surprise in the above quote, however, It is the following para that we should be a tab concerned about....

"Negotiations continue with the CMS for the reimbursement of previously invoiced but unpaid CX Bladder tests done for CMS patients up to 30 June 2020......there is no certainty whether these tests will be reimbursed... or at what price."

Having previously been told that many millions $$ were likely to be able to be claimed back via this process, PEB now seems to be preparing us for disappointment.

[pierre]

Nothing new in this that we didn’t know. Was hoping to see some numbers but I suppose they don’t give that out in newsletter.

Of course not. We will have to wait for the EOFY report for that info - it's only a month away.

I have to say though I was a little disappointed when I read in the newsletter that they have adopted "PIHSS" as the acronym for their Patient In-Home Sampling System. I think a four letter version without the "H" would have been really appropriate and possibly attracted more market attention. Just saying. (Can't find a "tongue-in-cheek" emoji.)

Anyway, things still appear to be tracking OK, if a little slower than might otherwise have been the case without Covid.

Onwards and upwards and looking forward to broker SP targets of around $1.60 being achieved by year-end.

[BigBob]

Having previously been told that many millions $$ were likely to be able to be claimed back via this process, PEB now seems to be preparing us for disappointment.

There is no change in their messaging from last year... This is from the HY announcement from November...:

"There is no certainty of any reimbursement on any of these tests performed prior to 30 June 2020, and there is no ability to reliably estimate the level of consideration that would be received if agreement can be reached with Novitas Solutions Inc over these previously performed tests."

[psychic]

Newsletter quietly offers a few corrections to past embellishments I think, before a disappointing result is published next month.

The big news items taking the SP from about .10 to $1.30 over the past 10 months have been as follows:

Inclusion in NCCN guidelines
PE made much of Cxbladder being included in the clinical pathway but this was an exaggeration in the extreme.
It wasn’t.
There is no mention of Cxbladder in there at all, surveillance is still Cystoscopy and cytology. The guidelines simply, with the weakest of recommendations (2B), now say that the additional use of Biomarkers (in general) may be considered in surveillance but that it was unclear whether the additional information was useful.

Guidelines current March 2021
https://www.nccn.org/professionals/p...df/bladder.pdf
The newsletter now confirms that they have more work to do before inclusion.

Deal with Kaiser June 2020

PE finally announced completion of Triage trial with KP in Nov 2016.
We still know nothing of the Commercial deal or number of tests being paid for.
But todays newsletter confirms that they are “using” Monitor only, Triage has not been adopted by KP

July 2020 LCD by CMS

Medicare now cover Cxbladder Monitor and Detect where medically necessary
Yet the Local Coverage Decision says Cxbladder is NOT considered medically necessary

https://www.cms.gov/medicare-coverag...d=38388&ver=13

The American Urological Assn directive last reviewed Jan 2021
https://www.auanet.org/guidelines/bl...sive-guideline
It says:
9. In surveillance of NMIBC, a clinician should not use urinary biomarkers in place of cystoscopic evaluation. (Strong Recommendation; Evidence Strength: Grade B)

So the “medically necessary” tests PEB is saying are now being reimbursed by CMS I suggest are only a small portion of those being completed. As for reimbursement of all those past tests, again, I think very few will have been “medically necessary” so good luck with that.

April 2021 United Healthcare covers Cxbladder

Well, they don’t, really. More exaggeration.

United has a Medicare Policy which is effectively back to back /underwritten by CMS as primary payer. Todays newsletter confirms that United doesn’t cover Cxbladder under its own Healthcare Plans. Neither do Aetna, Blue Cross or any others as far as I can see.
United has simply added the CPT codes so as to match Medicare for consistency

[Leftfield]

There is no change in their messaging from last year... This is from the HY announcement from November...:

"There is no certainty of any reimbursement on any of these tests performed prior to 30 June 2020, and there is no ability to reliably estimate the level of consideration that would be received if agreement can be reached with Novitas Solutions Inc over these previously performed tests."

Thanks BP - I was clearly being too optimistic.

[850man]

Newsletter quietly offers a few corrections to past embellishments I think, before a disappointing result is published next month.

The big news items taking the SP from about .10 to $1.30 over the past 10 months have been as follows:

Inclusion in NCCN guidelines
PE made much of Cxbladder being included in the clinical pathway but this was an exaggeration in the extreme.
It wasn’t.
There is no mention of Cxbladder in there at all, surveillance is still Cystoscopy and cytology. The guidelines simply, with the weakest of recommendations (2B), now say that the additional use of Biomarkers (in general) may be considered in surveillance but that it was unclear whether the additional information was useful.

Guidelines current March 2021
https://www.nccn.org/professionals/p...df/bladder.pdf
The newsletter now confirms that they have more work to do before inclusion.

Deal with Kaiser June 2020

PE finally announced completion of Triage trial with KP in Nov 2016.
We still know nothing of the Commercial deal or number of tests being paid for.
But todays newsletter confirms that they are “using” Monitor only, Triage has not been adopted by KP

July 2020 LCD by CMS

Medicare now cover Cxbladder Monitor and Detect where medically necessary
Yet the Local Coverage Decision says Cxbladder is NOT considered medically necessary

https://www.cms.gov/medicare-coverag...d=38388&ver=13

The American Urological Assn directive last reviewed Jan 2021
https://www.auanet.org/guidelines/bl...sive-guideline
It says:
9. In surveillance of NMIBC, a clinician should not use urinary biomarkers in place of cystoscopic evaluation. (Strong Recommendation; Evidence Strength: Grade B)

So the “medically necessary” tests PEB is saying are now being reimbursed by CMS I suggest are only a small portion of those being completed. As for reimbursement of all those past tests, again, I think very few will have been “medically necessary” so good luck with that.

April 2021 United Healthcare covers Cxbladder

Well, they don’t, really. More exaggeration.

United has a Medicare Policy which is effectively back to back /underwritten by CMS as primary payer. Todays newsletter confirms that United doesn’t cover Cxbladder under its own Healthcare Plans. Neither do Aetna, Blue Cross or any others as far as I can see.
United has simply added the CPT codes so as to match Medicare for consistency

Great update Psychic - those inconsistencies are significant, suggesting this latest investor update from PEB was misleading. Am I over reacting?