The seventh Annual Meeting of the Hematology/Oncology Carrier Advisory Committee (CAC) Network provided a forum for the discussion of variations in Medicare coverage, carrier relations, and off-label uses of drugs for cancer treatment. Attendees of the meeting included approximately 100 participants in the CAC process, including hematology, oncology.Many CAC representatives noted that the time needed for the CMS decision process is a problem. At least 6 to 9 months, and often longer, is needed for the evaluation process, and this timeframe does not keep pace with some of the rapid advances being made in cancer treatment.

In a keynote address prior to the meeting, Alton Wagnon, MD, CMD for Utah, presented a variety of ways to “bridge the gap” between CMDs and CAC representatives. At the meeting, Wagnon joined former CMDs Arnold Krubsack, MD, and Grant Steffen, MD, on a panel that fielded questions from attendees on how to gain support for coverage decisions. The panel noted that CAC representatives can be a reliable resource for a CMD and it encouraged representatives to introduce themselves to their CMD, to invite them to their state society meeting, and to be proactive by setting up regular face-to-face meetings with their CMD and offering to help.

Understanding the existing policies will help oncologists be fully informed before they present their situation to their CAC representative.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2794574/