Improving Medicare Coverage Decisions: Timelines and Consistency for New Services.
This law changes how Medicare approves coverage for new medical services and devices. It mandates a review of conditionally approved services within 10 years to ensure they remain effective and necessary. Furthermore, it requires Medicare officials to provide faster, clearer feedback on incomplete national coverage requests and ensures local coverage rules align with federal policies.
Key points
Establishes a 10-year deadline for Medicare to re-evaluate medical services or items initially covered under the conditional "Coverage with Evidence Development" process.
Requires Medicare to respond within 90 days to applicants seeking national coverage, specifying exactly what information is missing if the request is incomplete.
Ensures that local coverage rules set by contractors must be consistent with all national laws, regulations, and payment policies, reducing regional conflicts.
Expired
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