The goal of H.R. 5721, the Local Coverage Determination and Clarification Act is to ensure that coverage decisions are made by qualified health experts through a transparent process based on sound medical evidence. H.R. 5721 will improve transparency and boost accountability among government contractors who make decisions on a daily basis that impact the lives of millions of patients. Specifically, H.R. 5721 would: (1) require Medicare Administrative Contractors (MACs) to hold open and public Carrier Advisory Committee meetings that are on the record; (2) disclose the rationale for their local coverage determination (LCD) and the evidence upon which they relied at the outset of the LCD process rather than when the LCD is finalized; (3) provide interested parties with a meaningful reconsideration process outside of the self-interested review of a MAC that finalized the LCD being objected to; and (4) prohibit MACs from using LCDs as a way of getting around the higher standards of the national coverage determination (NCD) process.
To view H.R. 5721 click here.
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