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Easier Access to Innovative Drugs in Medicare Program

This act introduces a new appeal process for Medicare decisions denying or limiting drug coverage. Citizens will have the opportunity to publicly comment on such decisions, potentially increasing their chances of accessing modern therapies. The changes aim to ensure that approved drugs are covered by Medicare, unless there are justified reasons otherwise.
Key points
New Appeal Process: If Medicare denies coverage for an approved drug, citizens can request a review of that decision.
Public Voice: A 30-day public comment period will be introduced for Medicare drug decisions, allowing citizens to express their opinions.
Faster Access to New Drugs: Medicare will not be able to automatically deny coverage for newly approved drugs based on old decisions, potentially speeding up access to innovative therapies.
Increased Transparency: If a Medicare decision is changed, the clinical evidence and data leading to that change will be made publicly available.
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Additional Information
Print number: 117_HR_9358
Sponsor: Rep. Barragan, Nanette Diaz [D-CA-44]
Process start date: 2022-11-29