[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 8849 Introduced in House (IH)]
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118th CONGRESS
2d Session
H. R. 8849
To amend title XVIII of the Social Security Act to improve the national
and local coverage determination processes under the Medicare program.
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IN THE HOUSE OF REPRESENTATIVES
June 26, 2024
Mr. Smucker introduced the following bill; which was 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
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A BILL
To amend title XVIII of the Social Security Act to improve the national
and local coverage determination processes under the Medicare program.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Timeline Integrity for Medicare
Evidence Development Act of 2024'' or the ``TIMED Act of 2024''.
SEC. 2. IMPROVING THE NATIONAL AND LOCAL COVERAGE DETERMINATION
PROCESSES UNDER THE MEDICARE PROGRAM.
(a) In General.--Section 1862(l) of the Social Security Act (42
U.S.C. 1395y(l)) is amended by adding at the end the following new
paragraph:
``(7) Limitation on duration of coverage with evidence
development determinations.--
``(A) In general.--Subject to subparagraph (B), in
the case of a final decision under paragraph (3)(C)(i)
(including any such decision made on a class-wide
basis) made on or after the date of the enactment of
this paragraph that results in coverage of an item or
service pursuant to subsection (a)(1)(E), the Secretary
shall, not later than 10 years after the date on which
such coverage becomes effective pursuant to such
subsection, initiate a redetermination with respect to
such item or service.
``(B) Exception.--The Secretary may delay a
redetermination described in subparagraph (A) with
respect to an item or service for a period of time
determined appropriate by the Secretary if--
``(i) the Secretary finds that such item or
service is reasonable and necessary to carry
out the purposes described in section 1142; or
``(ii) the entity responsible for such item
or service requests such extension.
``(C) Posting of information.--Not later than 1
year after the date of the enactment of this paragraph,
and annually thereafter, the Secretary post on the
public website of the Centers for Medicare & Medicaid
Services the following information:
``(i) The number of items and services
covered under this title pursuant to subsection
(a)(1)(E).
``(ii) A description of each such item or
service.
``(iii) The year in which coverage of each
such item or service became effective pursuant
to such subsection.''.
(b) Provision of Explanation in Case of Certain Rejected
Requests.--Section 1862(l) of the Social Security Act (42 U.S.C.
1395y(l)), as amended by subsection (a), is further amended by adding
at the end the following new paragraph:
``(8) Requirement to provide explanation in case of certain
rejected requests.--With respect to each document received by
the Secretary on or after the date that is 1 year after the
date of the enactment of this paragraph that identifies itself
as a complete, formal request for a national coverage
determination (as described in the notice entitled `Medicare
Program; Revised Process for Making National Coverage
Determinations' (78 Fed. Reg. 48164) or a successor
regulation), the Secretary shall, not later than 90 days after
receipt of such document--
``(A) determine whether such document is a
complete, formal request for a national coverage
determination; and
``(B) in the case that the Secretary finds that
such document is not a complete, formal request for a
national coverage determination, transmit to the entity
submitting such document information on such finding
that includes a specification of additional information
needed to make such document a complete, formal request
for a national coverage determination.''.
(c) Improving Access to Items and Services Under Local Coverage
Determinations.--Section 1862(l)(5) of the Social Security Act (42
U.S.C. 1395y(l)(5)) is amended by adding at the end the following new
subparagraph:
``(E) Ensuring consistency with applicable rules.--
The Secretary shall require each Medicare
administrative contractor that develops a local
coverage determination to ensure that any such local
coverage determination does not conflict with any law,
ruling, regulation, national coverage determination,
payment policy, or coding policy.''.
(d) Funding.--There are authorized to be appropriated $1,000,000
for fiscal year 2024 for purposes of carrying out the amendments made
by this section.
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