Lawmakers should address the middlemen in our healthcare system. Chief among these middlemen are Medicare Administrative Contractors (MACs), asserts Jerry Rogers in RealClear Health.
MACs, which are private, multi-state health insurers contracted by the Centers for Medicare and Medicaid Services (CMS), are a “symptom of consolidation in the healthcare industry,” Rogers argues, threatening access to essential patient care.
An ongoing example from 2022 highlights this issue. Novitas, one of seven MACs nationwide, proposed a Local Coverage Determination (LCD) that would end Medicare coverage for 13 cancer diagnostic tests, which are critical for early intervention and preventative care.
Not only would this harm patients, but Rogers highlights serious concerns over the LCD process, including the exclusion of relevant studies and inconsistent standards for evidence.
Rogers explains that due to limited oversight, MACs have “[stood] in the way of critical cancer diagnostic testing for America’s senior citizens,” and Congress must step in to protect “innovative, cutting-edge healthcare options.”
Read Jerry Rogers’s full piece here.