House Passes Transparency Reforms to Medicare's Local Coverage Program
Published: Sep 12, 2018
WASHINGTON, /PRNewswire/ -- The House of Representatives passed the Local Coverage Determination Clarification Act, which aims to improve accountability and transparency in the process Medicare contractors use to make local coverage decisions. The legislation passed the House by a voice vote on September 12.
The College of American Pathologists (CAP) had strongly advocated for reforms in the original legislation, which would ensure local coverage determinations (LCDs) by Medicare contractors are made by qualified health experts, through a transparent process, based on sound medical evidence.
Key provisions in the bill approved and/or modified by the House include:
The House weakened key provisions sought by the CAP that would:
CAP President R. Bruce Williams, MD, FCAP expressed disappointment that the House has weakened the bill, but he thanked Reps. Lynn Jenkins (R-KS) and Ron Kind (D-WI) for introducing and advocating for the Local Coverage Determination Clarification Act. Dr. Williams urged the Senate to ensure the bill's original provisions are preserved, which will further protect patients from arbitrary decisions to deny coverage for Medicare services.
"With the reform legislation moving to the Senate, senators now must maintain key provisions to stop Medicare contractors from rubberstamping coverage decisions and using the LCD program to circumvent the more rigorous requirements of the National Coverage Determination process," Dr. Williams said. "These safeguards are needed to protect Medicare patients from flawed LCDs and ensure Medicare administrative contractors base all their coverage decisions on sound scientific evidence and advice from local physicians and other health care professionals."
Visit CAP.ORG to learn more about the Local Coverage Determination Clarification Act.
About the College of American Pathologists
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SOURCE College of American Pathologists