Medicare Local Coverage
Program

 

The College of American Pathologists and its pathology Carrier Advisory Committee (CAC) representatives advocate for fair reimbursement policies at the local Medicare level. By reviewing and commenting on pathology-related Local Coverage Determinations (LCDs) and policy changes before they are implemented, the CAP helps ensure that all pathologists are appropriately reimbursed for medically reasonable and necessary services provided to Medicare patients.

The CAP is grateful for the time and effort pathology CAC representatives spend participating in this important process. To assist them in their role, the Economic Affairs Department has implemented a program to assist with identifying, reviewing and developing comments on draft LCDs.

LCD Process Reform Legislation

The CAP developed a proposal to reform the LCD process to ensure coverage decisions are made by qualified health experts, through a transparent process, based on sound medical evidence. Reforms are necessary to improve transparency, boost accountability, and ensure that medical and scientific evidence is not used selectively. Furthermore, LCDs must not impede a physician’s medical judgment and deny patients access to medically necessary care.

Read the Issue Brief »

Additional Information

For more information on Medicare's local coverage process and the role of CAC representatives, refer to the Local Medicare Payment and CAP Coverage Program.

 

LCD Clarification Act Infographic

 

Contact Information

Please direct questions or comments to:

Nonda Wilson
nwilson@cap.org