Carrier Advisory Committee

Carrier Advisory Committees

Each state must have at least one Carrier Advisory Committee, which is established by a Medicare Administrative Contractor (MAC). MACs are private health insurers contracted with the Centers for Medicare and Medicaid Services (CMS) to process Medicare claims for a specific geographic region. There are currently 13 MAC regions.

CAC members include physicians (limited to one per specialty or provider type), a beneficiary representative, and representatives of other medical organizations. CACs serve as a mechanism for physicians to be made aware of and participate in the development of new Local Coverage Determinations (LCD), to discuss and amend administrative policies, and to serve as a link between Medicare and the local provider community.

According to the Medicare Program Integrity Manual Chapter 13 (Rev. 863, 02-12-19) Section 13.2.3 - Clinical Guidelines, Consensus Documents and Consultation:

• Prior to drafting and during the development of an LCD, if available the MACs shall supplement their research (see section 13.5.3) with clinical guidelines, consensus documents or consultation by experts (recognized authorities in the field), medical associations or other health care professionals for an advisory opinion, when applicable. When a MAC consults with an expert, they shall inform and obtain consent from the expert that their opinion may be used, disclosed publicly, and clearly identified as such within the proposed or final LCD. Acceptance by individual health care providers, or even a limited group of health care providers, does not indicate general acceptance of the item or service by the medical community.

ASH is committed to working with the MAC Medical Directors and help to provide experts in the field of hematology.

• If you are an ASH Member interested in being a subject matter expert, please complete this form.
• If you are a Medical Director seeking a hematology expert, please download and complete this form, and return via email to Katherine Stark at [email protected].

If you are interested in becoming a CAC representative of your state, please reach out to your state society or email Katherine Stark at [email protected].

ASH CAC Network Meeting

ASH sponsors the CAC Network Meeting as an opportunity for CAC representatives to meet, network, and strengthen relationships. The meeting allows participants to discuss Medicare-related coverage and policy issues (e.g., LCDs), draft policies, and the relationship between Medicare and the provider community. This diverse group of stakeholders also has an opportunity to discuss possible solutions to real-world issues. If you have a topic related to Medicare coverage that you would like to see presented at an upcoming meeting please reach out to ASH staff.

ASH hosts the Carrier Advisory Committee (CAC) Network Meeting annually at ASH Headquarters in Washington, DC. This meeting includes invited individuals from the following groups:

• ASH Committee on Practice
• ASH Reimbursement Subcommittee
• MAC Medical Directors
• Hematology CAC Representatives
• State Society Presidents
• State Society Executive Directors

Previous CAC Network Meeting Materials

• 2023 Meeting Notebook
• 2022 Meeting Notebook
• 2021 Meeting Notebook
• 2020 Fall Meeting Notebook
• 2020 Summer Meeting Notebook
• 2019 Meeting Notebook
• 2018 Meeting Notebook
• 2017 Meeting Notebook
• 2016 Meeting Notebook
• 2015 Meeting Notebook

For more information on the CAC process or previous or upcoming CAC Network Meetings, please email Katherine Stark at [email protected].