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Contact:
Mark E. Brager
202-434-7244
mbrager@advamed.org
March 31, 2017

Senate Bill Would Improve Medicare LCD Process

WASHINGTON, D.C. – The Advanced Medical Technology Association (AdvaMed) issued the following statement from President and CEO Scott Whitaker after introduction of bipartisan legislation (S. 794) in the U.S. Senate designed to ensure Medicare beneficiary access to needed medical technologies and services:

“Medicare Administrative Contractors (MACs) are responsible for decisions that impact millions of Medicare beneficiaries, determining which technologies, procedures and services are available to them.

“Unfortunately, the Local Coverage Determination (LCD) process MACs use is flawed, lacks transparency and does not provide meaningful opportunity for stakeholder input or appeals. As a result, American patients are at risk of being denied access to technologies and services they need.

“By improving the transparency and accountability of the LCD process, the legislation introduced by Sens. Johnny Isakson (R-Ga.), Thomas Carper (D-Del.), Debbie Stabenow (D-Mich.) and John Boozman (R-Ark.) will help address this issue.

“Specifically, the legislation would:

  • Require open and public MAC meetings that are on the record;
  • Require disclosure by MACs of the rationale for an LCD and the evidence for that decision at the beginning of the LCD process;
  • Provide stakeholders with a meaningful reconsideration process for an LCD; and
  • Prohibit MACs from adopting an LCD from another jurisdiction without first conducting its own independent evaluation of the evidence.

“AdvaMed commends Sens. Isakson, Carper, Stabenow and Boozman for their leadership on this issue. This bill builds on provisions to improve the LCD process in the recently passed 21st. Century Cures Act and will foster greater transparency, consistency and objectivity in the process, which will ultimately benefit Medicare beneficiaries. We look forward to working with members of Congress, CMS and other key stakeholders to advance this legislation.”