WASHINGTON, D.C. – Congressman Neal Dunn, M.D. (Florida-02) and Congresswoman Claudia Tenney (New York-24) recently introduced the Timely Access to Coverage Decisions Act of 2023, which will ensure that local coverage determinations for the Medicare program are made in a timely manner.

“There are many uncertainties in life, but no American should be uncertain about their access to care,” said Congressman Dunn. “My bill seeks to streamline local coverage determinations so seniors in my district and nationwide can receive quality care without delay.”

"The Timely Access to Coverage Decisions Act of 2023 is an important step towards reducing red tape for medical innovation and choice," said Congresswoman Tenney. "By streamlining local coverage determinations, this legislation ensures that seniors across the nation, including those in NY-24, can access cutting edge quality care with the potential to reduce costs and improve healthcare outcomes. This is a vital step towards providing our seniors with the top-notch healthcare they deserve."

Local coverage determinations are decisions made by regional Medicare Administrative Contractors (MACs) about coverage of medical items and services in the Medicare program. These coverage decisions impact an array of individuals, from cancer patients to those who have lost limbs or need skin grafts. Uneven approval timelines result in inadequate care, delays in needed treatments, and uncertainty about access to care. Innovative products must be promptly evaluated to provide our nation’s seniors with top-notch care.

The Timely Access to Coverage Decisions Act will accomplish this goal by requiring that MACs respond to local coverage determination requests within 30 days. In the case of an incomplete request, the MAC would be required to notify of additional needed information within 60 days. In the case of a complete request, a coverage determination would be required within nine months.

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