To amend title XVIII of the Social Security Act to provide a review process for adverse national coverage determinations with respect to drug coverage under the Medicare program.
About This Bill
Committee
Latest Action · June 24, 2026
Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Access to Innovative Treatments Act of 2026
This bill requires the Centers for Medicare & Medicaid Services (CMS) to review adverse national coverage determinations of drugs under Medicare within 30 days of receiving a request to do so.
Specifically, the CMS must review within 30 days any denials or limitations of coverage that are inconsistent with the drug's approval by the Food and Drug Administration (FDA). The bill's requirements do not apply if the CMS already conducted such a review within a two-year period.
The bill also prohibits the CMS from applying prior coverage determinations that were made for drugs before they were approved by the FDA if such determinations are inconsistent with the drug's approval.
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