- Home
- Advocacy
- Latest News and Practice Data
- CAP Asks Insurer Cigna to Update its Scientifically Inaccurate Special Stains Coverage Policy
On February 21, Cigna, as the Medicare Part A/B Medicare Administrative Contractor (MAC) for Ohio and Kentucky, held an open meeting in response to the CAP’s reconsideration request regarding a local coverage determination (LDC) on special histochemical stains & immunohistochemical stains. The CAP has long advocated for the withdrawal of this LCD since it was issued in 2015. The CAP formally submitted a request for reconsideration on January 4, 2022, citing the policy’s medically and scientifically inaccurate language and its attempt to define good pathology practice.
The CAP asked to reconsider the current version of the LCD during the open public meeting on revising the LCD. Jonathan Myles, MD, FCAP, chair of the Council on Government and Professional Affairs, and Debra Zynger, MD, FCAP, who is a professor and director of urologic pathology at Ohio State University Medical Center, provided presentations on the section of the LCD for special stains and/or IHC for prostate pathology. In addition, they thanked Cigna for proposing updates that the CAP requested in its reconsideration and continued to advocate for removing some of the limitations for prostate stains. The CAP will again submit formal comments by March 5.