April 22, 2024

Updated June 17, 2024

On June 5, APMA led a gathering of the Contractor Advisory Committee (CAC) Engagement Coalition of more than 20 organizations, including the AMA, in a hybrid meeting with CMS to address ongoing issues with the Local Coverage Determination development process. During the meeting, the coalition advocated that the new guidelines under 21st Century Cures are incorrectly interpreted to minimize the role of CAC representatives in Medicare Administrative Contractor (MAC) policy development; addressed a number of examples of current issues with the process; and highlighted a few solutions to resolve these issues, including by applying the coalition’s Principles for Sound Local Coverage Policies. CMS has agreed to additional meetings to discuss these potential solutions and has also offered to assist in MAC-specific issues. You can read more about the CAC process at www.apma.org/cacpiac.

Previously, on April 17, APMA hosted a gathering of the Contractor Advisory Committee (CAC) Engagement Coalition of more than 20 organizations to address ongoing issues with the Local Coverage process. Following multiple sessions with CMS, the coalition has opted to arrange a face-to-face meeting with CMS on May 17 to express its frustrations and concerns.

Repeatedly, the coalition has highlighted its collective concerns regarding the current implementation of local coverage policies, including concerns about the diminishing importance of CAC representatives' advisory roles, insufficient notice and comment procedures, procedural hurdles, and a lack of transparency. APMA anticipates that this forthcoming meeting will reflect an important step toward continuing to address our concerns.

For previous activities in this area, read this APMA Weekly Focus article.

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