3.0.0 5721 2023-01-11T13:33:26Z 2023-01-11T13:33:26Z House HR 2016-07-11 114 [Congressional Record Volume 162, Number 111 (Monday, July 11, 2016)]From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]By Ms. JENKINS of Kansas:H.R. 5721.Congress has the power to enact this legislation pursuantto the following:Article I, Section 8, Clause 1[Page H4660]]]> hswm00 Ways and Means Committee House Standing hswm02 Health Subcommittee Referred to 2016-07-19T13:57:30Z Referred to 2016-07-11T16:02:10Z hsif00 Energy and Commerce Committee House Standing Referred to 2016-07-11T16:02:15Z Local Coverage Determination Clarification Act of 2016 114 3392 S 2016-09-22 Read twice and referred to the Committee on Finance. Identical bill CRS 2016-07-19 hswm02 Health Subcommittee 1 House committee actions Referred to the Subcommittee on Health. Committee 2016-07-11 Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned. IntroReferral H11100 2 House floor actions hsif00 Energy and Commerce Committee 2016-07-11 Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned. IntroReferral H11100-A 9 Library of Congress 2016-07-11 Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned. IntroReferral H11100 2 House floor actions hswm00 Ways and Means Committee 2016-07-11 Introduced in House IntroReferral Intro-H 9 Library of Congress 2016-07-11 Introduced in House IntroReferral 1000 9 Library of Congress J000290 Rep. Jenkins, Lynn [R-KS-2] Lynn Jenkins R KS 2 N K000188 Rep. Kind, Ron [D-WI-3] RON KIND D WI 3 2016-07-11 True H001045 Rep. Harper, Gregg [R-MS-3] Gregg Harper R MS 3 2016-07-14 False S000250 Rep. Sessions, Pete [R-TX-32] PETE SESSIONS R TX 32 2016-09-09 False B001294 Rep. Blum, Rod [R-IA-1] Rod Blum R IA 1 2016-09-09 False M001158 Rep. Marchant, Kenny [R-TX-24] Kenny Marchant R TX 24 2016-09-20 False P000258 Rep. Peterson, Collin C. [D-MN-7] COLLIN PETERSON D MN C. 7 2016-09-21 False P000591 Rep. Price, Tom [R-GA-6] Tom Price R GA 6 2016-09-22 False K000382 Rep. Kuster, Ann M. [D-NH-2] Ann Kuster D NH M. 2 2016-09-26 False B001257 Rep. Bilirakis, Gus M. [R-FL-12] Gus Bilirakis R FL M. 12 2016-11-29 False S001187 Rep. Stivers, Steve [R-OH-15] Steve Stivers R OH 15 2016-11-29 False R000586 Rep. Renacci, James B. [R-OH-16] James Renacci R OH B. 16 2016-11-29 False B001243 Rep. Blackburn, Marsha [R-TN-7] Marsha Blackburn R TN 7 2016-11-29 False C001038 Rep. Crowley, Joseph [D-NY-14] JOSEPH CROWLEY D NY 14 2016-11-29 False T000469 Rep. Tonko, Paul [D-NY-20] Paul Tonko D NY 20 2016-12-05 False T000460 Rep. Thompson, Mike [D-CA-5] MIKE THOMPSON D CA 5 2016-12-08 False Health Administrative law and regulatory procedures Administrative remedies Department of Health and Human Services Government information and archives Medicare Public contracts and procurement Health 00 2016-07-11 Introduced in House 2016-09-16T19:46:33Z Local Coverage Determination Clarification Act of 2016

This bill amends title XVIII (Medicare) of the Social Security Act to revise the process by which Medicare administrative contractors (MACs) issue and reconsider local coverage determinations (LCDs) that: (1) are new, (2) restrict or substantively revise existing LCDs, or (3) are otherwise specified in regulation. (MACs are private insurers that process Medicare claims within specified geographic areas.)

Before such an LCD may take effect, the MAC issuing the determination must, with respect to each geographic area to which the determination applies:

  • publish online a proposed version of the determination and other specified, related information;
  • convene one or more public meetings to review the draft determination, receive comments, and secure the advice of an expert panel;
  • post online a record of the minutes from each such meeting;
  • provide a period for submission of written public comments; and
  • post online specified information related to the rationale for the final determination.

Upon the filing of an applicable request by an interested party with regard to the reconsideration of a specified LCD, the MAC that issued the determination shall:

  • provide specified information related to whether the determination failed to correctly apply qualifying relevant evidence, exceeds the scope of its intended purpose, fails to apply as intended, or is otherwise erroneous;
  • preserve the determination, modify the determination, or rescind the determination in part; and
  • make publicly available a written description of such action.

An interested party may appeal a reconsideration decision to the Centers for Medicare & Medicaid Services (CMS).

CMS shall appoint a Medicare Reviews and Appeals Ombudsman to carry out specified duties with regard to LCDs.

]]> Local Coverage Determination Clarification Act of 2016 Display Title Local Coverage Determination Clarification Act of 2016 Short Titles as Introduced Local Coverage Determination Clarification Act of 2016 Official Title as Introduced To amend title XVIII of the Social Security Act in order to improve the process whereby medicare administrative contractors issue local coverage determinations under the Medicare program, and for other purposes. Introduced in House 2016-07-11T04:00:00Z https://www.govinfo.gov/content/pkg/BILLS-114hr5721ih/xml/BILLS-114hr5721ih.xml 2016-07-19 Referred to the Subcommittee on Health. text/xml EN Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain. Congressional Research Service, Library of Congress This file contains bill summaries and statuses for federal legislation. A bill summary describes the most significant provisions of a piece of legislation and details the effects the legislative text may have on current law and federal programs. Bill summaries are authored by the Congressional Research Service (CRS) of the Library of Congress. As stated in Public Law 91-510 (2 USC 166 (d)(6)), one of the duties of CRS is "to prepare summaries and digests of bills and resolutions of a public general nature introduced in the Senate or House of Representatives". For more information, refer to the User Guide that accompanies this file.