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Medicare Audits Update Orthopaedic CAC Network Orthopaedic CAC Network David Templeman, MD | October 20, 2012.

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Presentation on theme: "Medicare Audits Update Orthopaedic CAC Network Orthopaedic CAC Network David Templeman, MD | October 20, 2012."— Presentation transcript:

1 Medicare Audits Update Orthopaedic CAC Network Orthopaedic CAC Network David Templeman, MD | October 20, 2012

2 What is a CAC? Contractor Advisory Committee Contractor Advisory Committee A group of clinicians that advises Medicare contractors about coverage determinations A group of clinicians that advises Medicare contractors about coverage determinations

3 Why Should We Care? Other specialties and non-physicians will speak for us if we do not speak for ourselves Other specialties and non-physicians will speak for us if we do not speak for ourselves Some coverage determinations have dramatic consequences (TJA) Some coverage determinations have dramatic consequences (TJA)

4 AK & HI not to scale Medicare Administrative Contractor Jurisdictions

5 About CACs Each CAC advises its MAC by reporting to its contractor medical director (CMD) Each CAC advises its MAC by reporting to its contractor medical director (CMD) A MAC that covers 5 states will have 5 different CACs A MAC that covers 5 states will have 5 different CACs Each of those 5 orthopaedic surgeons should have a consistent message regarding orthopaedic procedures for the CMD Each of those 5 orthopaedic surgeons should have a consistent message regarding orthopaedic procedures for the CMD

6 What Does a CAC Rep Do? Meet 3-4 times per year Meet 3-4 times per year Review proposed LCDs Review proposed LCDs About ALL types of medical services, not just orthopaedic About ALL types of medical services, not just orthopaedic Report back to state orthopaedic society and the AAOS Report back to state orthopaedic society and the AAOS

7 Orthopaedic CAC Network The Network will share information in order to: Ensure a consistent message from orthopaedic surgeons Ensure a consistent message from orthopaedic surgeons Learn what may be coming to a MAC near you Learn what may be coming to a MAC near you

8 Orthopaedic CAC Network The Network will: Meet at the AAOS Annual Meeting Meet at the AAOS Annual Meeting Hold 4 teleconferences annually Hold 4 teleconferences annually Produce/receive 6 newsletters annually Produce/receive 6 newsletters annually

9 Orthopaedic CAC Network Policy recommendations will be made by the Board of Directors and its Coverage Determinations Project Team Policy recommendations will be made by the Board of Directors and its Coverage Determinations Project Team Network led by BOC executives Network led by BOC executives

10 Orthopaedic CAC Network AAOS has identified CAC representatives in 27 states and DC AAOS has identified CAC representatives in 27 states and DC Vacancies for orthopaedic surgeons in 19 states Vacancies for orthopaedic surgeons in 19 states No information for AR, HI, MD No information for AR, HI, MD

11 Where Are the Vacancies? Alaska Alaska Colorado Colorado Idaho Idaho Illinois Illinois Indiana Indiana Kansas Kansas Kentucky Kentucky Massachusetts Massachusetts Missouri Missouri Montana Montana Nebraska Nebraska New Hampshire New Hampshire New York New York North Carolina North Carolina Ohio Ohio Utah Utah Washington Washington West Virginia West Virginia Wyoming Wyoming

12 How Do We Fill a Vacancy? Nominate someone through your state orthopaedic society Nominate someone through your state orthopaedic society Contact your CMD and tell him/her of the nomination Contact your CMD and tell him/her of the nomination If you need your CMDs contact information, contact Ashlen at If you need your CMDs contact information, contact Ashlen at

13 Who is My States CAC? Look at the display outside the door Look at the display outside the door Contact Ashlen for more information at Contact Ashlen for more information at


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