APMA participated in a Contractor Advisory Committee (CAC) Engagement Coalition meeting with CMS staff and coalition partners, to discuss ongoing efforts to strengthen engagement with the Medicare Local Coverage Determination (LCD) process. APMA’s continued engagement with CMS to improve the CAC and LCD process is an important part of its larger strategy to ensure podiatrists’ expertise is represented in coverage policy discussions, and ultimately, that podiatrists are able to practice to the full extent of their training and continue to provide services that their patients need.
During the meeting, CMS provided updates on its efforts to improve CAC engagement and on the evolving Provider Engagement Model (PEM), which is intended to create more flexible opportunities for specialty societies and clinicians to provide input outside of formal evidentiary CAC meetings.
Coalition members shared feedback on ongoing challenges with the current CAC and LCD development process. Key themes included the need for more consistent and timely notice of LCD engagement opportunities, clearer information about the types of subject matter experts Medicare Administrative Contractors (MACs) are seeking for evidentiary CAC panels, and more meaningful opportunities for specialty societies to discuss proposed LCD topics and highlight clinical expertise that may not be captured in published literature during the comment period. CMS acknowledged these concerns and indicated that it is continuing to work with MACs on approaches that improve engagement while maintaining transparency and compliance with statutory limits.
APMA will continue to participate in these discussions and advocate for a more transparent, consistent, and clear LCD process that allows clinical expertise to be heard in ways that are meaningful for both podiatric physicians and the patients they serve.
Contact the APMA Advocacy Department with any questions at advocacy@apma.org.