This bill, introduced in September 2023, aims to prevent Medicare from using local coverage rules to restrict patient access to medications and medical devices that have already been approved nationally. The legislation requires Medicare officials to annually review local coverage determinations—rules created by regional Medicare contractors—to identify any that go beyond national coverage decisions and impose unnecessary restrictions on FDA-approved treatments and devices. When such restrictions are found, Medicare contractors must revise them within 180 days. The bill also requires Medicare contractors developing new local coverage rules to ensure they don't limit access to nationally covered items and services, and mandates greater transparency by requiring reviewers to publicly disclose their names and qualifications. Starting in 2025, the Secretary of Health and Human Services must submit annual reports to Congress documenting the findings from these reviews and any revised coverage determinations.
Take Action
Your position
Add a comment
to comment on this bill.
Annotate the text
Highlight any passage on the Summary or Full Text tab to attach a note. Annotations appear on the Annotations tab.