Richard Carmona, MD, MPH, FACS, was the 17th surgeon general of the United States and currently serves as a distinguished laureate professor at the University of Arizona. In a recent op-ed in The Washington Times, Dr. Carmona urged CMS to fix the MAC system.
“President Trump’s new administration has the opportunity to address a critical but little-known aspect of our country’s health care system: Medicare Administrative Contractors, which are restricting access to critical diagnostic testing for cancer patients.
Most Americans are familiar with insurers such as Blue Cross Blue Shield or United Healthcare. Less familiar are MACs, a network of private health care insurers contracted by the Centers for Medicare and Medicaid Services to act as intermediaries between health care providers and Medicare beneficiaries.
During my tenure as surgeon general of the United States, we realized that our nation’s health insurance program needed desperate reform. Thanks to President Bush’s leadership, we embarked on an administrative-wide effort to overhaul Medicare for the first time in the program’s history.
Ultimately, we were successful. The passage of the Medicare Prescription Drug, Improvement and Modernization Act set into motion the greatest advancement in health care coverage for America’s senior citizens. This included creating the MAC system to improve claim processing.
At the time, President Bush said, ‘With this law, we are providing more access to comprehensive exams, disease screenings and other preventative care so that seniors across this land can live better and healthier lives.’
He was right. Since then, MACs have processed millions of claims, ensured Medicare dollars are spent appropriately and safeguarded the compliance of Medicare regulations. However, more attention is needed to the far-ranging implications of coverage determinations made by MACs.”
Read more from former U.S. Surgeon General Dr. Richard Carmona in the Washington Times.