Timely Access to Coverage Decisions Act
Term Dictionary
If you come across any unfamiliar words while reading, these resources can help make everything clearer. Pick whichever one works best for you!
- Congress.gov Legislative Glossary - Comprehensive congressional terms
- NVFC Congressional Terms Glossary - Concise, easy-to-understand definitions
The gist
- Sets hard deadlines for Medicare contractors reviewing local coverage decisions, so patients and providers get faster answers on what Medicare pays for.
Who wins, who loses
- Wins: Medicare patients, doctors, device makers, and hospitals waiting on coverage answers for new treatments.
- Loses: Medicare Administrative Contractors (MACs) facing tighter workloads and stricter transparency rules.
What it does
- Requires MACs to decide if a Local Coverage Determination (LCD) request is complete within 60 days.
- Sets a 1-year deadline for final decisions on complete LCD requests and reconsiderations.
- Mandates public draft posting, open meetings, expert panels, and a 30-day comment period before new LCDs take effect.
- Lets patients and providers appeal to the Health Secretary for agency review.
Why should I care?
Medicare covers 65 million Americans, including grandparents and family members with disabilities. Supporters say current delays block access to newer treatments and leave doctors guessing. Critics argue the one-year deadlines could rush decisions on complex science and overload contractors. Where do you land? Vote below and use "Tell Your Rep" to make sure your voice reaches Congress.