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Medicare Coverage
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The Medicare program is administered at the local level through contracted insurance companies, commonly called "Carriers." CMS is replacing its current claims payment contractors (fiscal intermediaries and carriers), however, with new contract entities called Medicare Administrative Contractors (or A/B MACs). A Medicare Carrier (or A/B MAC) is responsible for developing payment policies for those state(s) within its jurisdiction. These policies are called Local Medical Review Policies (LMRPs) or Local Coverage Determinations (LCDs). In addition to considering medical literature and comments from local medical societies, medical consultants and the public, each Carrier (or A/B MAC) must form a Carrier Advisory Committee (now called Contractor Advisory Committee), or CAC, to assist in the development of LMRPs/LCDs. The purpose of the CAC, in addition to participating in policy development, is to serve as a mechanism for discussing and improving administrative policies within the Carrier's (or A/B MACs) authority, and to provide a forum for exchanging information between Medicare contractors and physicians.
In an effort to assist members in understanding Medicare's Carrier/Contractor Advisory Committee (CAC) process, ASCO has developed this Web site, which features background information on the CAC process, contact information for those individuals who participate in that process, information on how to access local policies (LMRPs/LCDs) from Medicare Carriers around the country, and other related information. For further information, contact ascocac@asco.org.
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State Contact Information:
Contact information for your state's Medicare Carrier, Carrier Medical Director, Oncology/Hematology Society and CAC Representative
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Local Coverage Policy Search:
Search for local coverage policies in CMS's Medicare Coverage Database
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CAC Networking Meeting:
Information about the annual meeting of CAC representatives, state hematology/oncology society presidents, and committee members from ASCO, ASH and SGO
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What is a CAC:
Background information on the CAC/LMRP/LCD processes, as well as ASCO's efforts in this area
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CAC News:
Archived informational alerts about CAC-related activities specific to oncology and hematology, including updates to the ASCO CAC Web site, local open policy meetings on specific LMRPs/LCDs, and national coverage issues
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Educational Resources:
Medicare carrier and payment-related information from CMS and other resources
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Coverage Issues:
Notify ASCO staff regarding coverage issues you are having with your Medicare Carrier
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