ACR Leads Coalition in CMS LCD Policy Meeting

ACR^® led a coalition of 20 medical organizations in a meeting with CMS to discuss concerns about local coverage determination (LCD) policies and provider engagement. This was the coalition’s first meeting with CMS since June 2024.

The group met with Elizabeth Truong, director of the Division of Policy Coordination and Implementation in the Center for Clinical Standards and Quality, and her staff. The timing was ideal, as CMS recently released its 2025–2028 CCSQ Strategic Roadmap, intended to accelerate coverage by modernizing the National Coverage Determination process and improving the LCD process for greater consistency across Medicare Administrative Contractor (MAC) jurisdictions. By reviewing and commenting on NCDs, LCDs and proposed policy changes, the ACR Contractor Advisory Committee Network helps ensure members are properly reimbursed for medically reasonable and necessary services provided to Medicare patients.

During the meeting, Mark Alson, MD, FACR, a 25-year Contractor Advisory Committee (CAC) member, shared examples from provider engagement meetings held by Noridian and now piloted in the NGS Medicare Administrative Contractor jurisdiction. While these meetings are occurring, they are not consistently offered across all MACs and often do not include discussion of current or upcoming LCD topics.

ACR and its coalition partners stressed the need for strong clinical input in LCD development. The LCD process defines the reasonable and necessary criteria that guide coverage decisions, ensuring patients with qualifying diagnoses receive appropriate services. The coalition emphasized that evidence-based literature, clinical experience and multispecialty feedback lead to better outcomes. CMS leaders acknowledged these concerns and welcomed continued collaboration. The coalition will support CMS by offering subject matter experts and participating in future discussions.

For questions about LCD policies or this outreach, contact Alicia Blakey, ACR Manager of Economic Policy.