Volunteer as a Subject Matter Expert for Evidentiary Contractor Advisory Committee (CAC) Meetings

What is an Evidentiary CAC Meeting?

An Evidentiary CAC Meeting is a structured expert consultation focused on the published evidence for a specific policy topic. The Medicare Administrative Contractor (MAC) or a multi-MAC workgroup develops questions for a panel of Subject Matter Experts (SMEs) based on the evidence review and invites SMEs whose expertise matches the topic. Participants are expected to anchor their responses in specific studies, systematic reviews, clinical guidelines, registries, or other relevant evidence and to distinguish evidence from personal opinion. The purpose is to help the MAC understand the quality and applicability of the evidence, clarify gaps, and identify where uncertainty remains. The meeting is advisory and is not a vote on coverage.

Who is an Ideal SME?

Subject matter experts (SMEs) are recognized authorities in clinical care, evidence evaluation, or related fields and may volunteer to assist MACs during Evidentiary CAC meetings. SMEs provide independent, advisory input on the quality, strength, limitations, and applicability of evidence for a topic that may be considered for a local coverage determination (LCD).

An ideal SME has relevant expertise and can evaluate evidence objectively. Because subject matter expertise often comes with professional relationships, complete disclosure is essential. The strongest candidate is as free as reasonably possible from actual, potential, or apparent financial, professional, organizational, or personal interests that could impair objectivity or create a reasonable perception of bias.

  • Recognized expertise that is relevant to the policy topic and the Medicare population.
  • Ability to critically appraise evidence, explain study methods and limitations, and distinguish evidence from opinion.
  • No direct financial or other stake in a particular coverage outcome.
  • Not primarily participating to promote a specific product, service, company, industry, professional interest, or predetermined position.
  • Complete and timely disclosure of relevant relationships, including employment, consulting, research support, grants, speaking, ownership, patents, royalties, leadership roles, guideline roles, advocacy, and other interests tied to the topic.
  • Willingness to comply with MAC conflict management measures, including public disclosure, limits on participation, or recusal.

A disclosed relationship does not automatically disqualify a candidate. The MAC evaluates the nature, relevance, timing, and magnitude of each relationship and whether it can be managed without compromising the integrity of the discussion. A candidate may not be selected, or may be asked to recuse, when a conflict cannot be adequately managed.

Clinical Health Care Professionals

Clinical professionals contribute current knowledge of patient care, practice settings, treatment pathways, outcomes, and the applicability of evidence to the Medicare population. Clinical health care professionals interested in serving as an SME should submit the following to CACMeeting@noridian.com:

  • Up-to-date resume or CV
  • Key areas of expertise
  • Should you be selected for a future CAC topic, we will ask you to complete a conflict of interest (COI) form

Nonclinical Health Care Professionals and Evidence Experts

Nonclinical health care professionals and evidence experts contribute methods expertise that strengthens interpretation of study design, risk of bias, certainty, generalizability, and outcomes. Interested individuals should submit the following to CACMeeting@noridian.com:

  • Up-to-date resume or CV
  • Area of expertise, such as clinical trial methodology, epidemiology, biostatistics, evidence review, outcomes research, health technology assessment, systematic review, guideline development, medical policy, or a related discipline
  • Should you be selected for a future CAC topic, we will ask you to complete a COI form

Before Noridian announces an Evidentiary CAC Meeting, individuals with expertise relevant to the topic may be invited to participate as SMEs. Participants should be able to critically appraise published clinical literature and respond to defined questions about what the evidence supports, does not support, or remains insufficient to support. SME input informs the MAC, but the MAC retains responsibility for all coverage decisions.

Process

  • Receipt. Noridian will acknowledge each submission by email.
  • Roster review. The MAC will review qualifications and disclosures to create and maintain a roster of available SMEs for its jurisdiction. Inclusion on the roster does not guarantee selection.
  • Topic matching. When planning an Evidentiary CAC Meeting or other consultation, the MAC may invite individuals whose expertise is pertinent to the topic and who can contribute to a balanced panel.
  • Before participation. Selected SMEs may receive background materials and evidence questions in advance. They must complete or update COI disclosures and consent to public use and attribution of their advisory opinions, as applicable.
  • Selection factors. The MAC retains discretion to select participants based on topic needs, expertise, relevant experience, evidence appraisal skills, potential or apparent bias, COI, balance of perspectives, availability, and other eligibility considerations.
  • COI management. The MAC may disclose a relationship, limit a participant role, request recusal, or decline participation when a conflict cannot be adequately managed.
  • Voluntary service. Participation is voluntary. MACs do not provide an honorarium or other compensation, and participants are responsible for their expenses.

Ways to Engage in MAC Policy Development in Addition to the Evidentiary CAC Meeting

Individuals do not need to be selected as SMEs to participate in every coverage pathway. Depending on the policy topic and stage of development, stakeholders may:

  • Attend an Evidentiary CAC Meeting as an observer, subject to the meeting procedures.
  • Participate in an Open Meeting and submit formal written comments during the public comment period.
  • Request a Provider or Stakeholder Engagement Meeting through the MAC published process.

CMS and the MACs use three meeting pathways. The appropriate pathway depends on the stage of policy development and the type of input a stakeholder wishes to provide.

Meeting Pathway Purpose and Timing How to Participate
Evidentiary CAC Meeting A collaborative advisory forum for expert consultation on published literature, typically conducted during or after the MAC’s evidence review and before a proposed LCD is developed. Invited Subject Matter Experts (SMEs) and CAC members help address defined evidence questions, identify evidence gaps, and discuss areas of certainty and uncertainty. The public may attend and observe in a listen-only capacity. Interested experts are encouraged to apply for the SME roster to be considered for current or future advisory opportunities. Selected participants review meeting materials, complete and update conflict of interest disclosures, respond to assigned evidence questions, and contribute to evidence-focused discussions that help inform the contractor's understanding of the topic.
Open Meeting A public engagement forum held after a proposed LCD is published and required as part of the LCD development process. The MAC presents the evidence review and rationale supporting the proposed policy and invites stakeholder perspectives on the proposal. Interested parties are encouraged to participate by attending the meeting, requesting presentation time in accordance with MAC instructions, and sharing clinical, operational, or patient-centered perspectives related to the proposal. Formal comments must also be submitted in writing during the public comment period to ensure they are considered and addressed in the LCD process.
Engagement Meeting, including Provider Engagement Meetings A flexible engagement pathway designed to support ongoing collaboration among CAC members, providers, professional and specialty societies, beneficiaries, manufacturers, and other stakeholders. These meetings may focus on education, listening sessions, emerging practice trends, policy questions, potential LCD requests, or other topics of mutual interest. They are separate and distinct from Evidentiary CAC Meetings and Open Meetings. Stakeholders are encouraged to engage with the MAC through its published engagement process or in response to MAC outreach. Participants may propose topics, identify areas of concern or opportunity, provide supporting information, and contribute perspectives that help inform future policy discussions. Engagement Meetings create opportunities for dialogue and relationship-building but do not replace formal LCD requests or written public comments during an active LCD process.

Questions

Questions about becoming a SME may be directed to CACMeeting@noridian.com.

Last Updated Nov 04 , 2026