Local Coverage Determination Clarification Act of 2018
Latest action · Sep 17, 2018 Received in the Senate and Read twice and referred to the Committee on Finance.
Progress
Where this bill reached, and when. A stage with no date was not reached; one that failed a vote and later carried shows the date it carried.
- IntroducedAug 1, 2017
- Passed HouseSep 12, 2018
- Passed SenateNot reached
- To the PresidentNot reached
- Became lawNot reached
Summary
Local Coverage Determination Clarification Act of 2017
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).
The CMS shall appoint a Medicare Reviews and Appeals Ombudsman to carry out specified duties with regard to LCDs.
Cosponsors 81
Members who signed on, in the order they did. Signatures ran from Aug 1, 2017 to Sep 10, 2018; 1 is an original cosponsor, there from the day it was introduced.
| Seat | Cosponsor | Signed on | |
|---|---|---|---|
| D-WI | Ron Kind | Original | Aug 1, 2017 |
| R-PA | Patrick Meehan | Aug 25, 2017 | |
| R-TX | Pete Sessions | Aug 25, 2017 | |
| D-NY | Joseph Crowley | Sep 6, 2017 | |
| R-OK | Markwayne Mullin | Sep 7, 2017 | |
| D-MN | Collin C. Peterson | Sep 14, 2017 | |
| D-NY | Eliot L. Engel | Oct 3, 2017 | |
| R-MI | Fred Upton | Oct 3, 2017 | |
| R-TX | Kenny Marchant | Oct 3, 2017 | |
| D-NY | Paul Tonko | Oct 3, 2017 | |
| D-MA | Seth Moulton | Oct 3, 2017 | |
| D-AL | Terri A. Sewell | Oct 3, 2017 | |
| D-IA | David Loebsack | Oct 12, 2017 | |
| D-IL | Bobby L. Rush | Oct 19, 2017 | |
| D-IL | Janice D. Schakowsky | Oct 19, 2017 |
Committees 3
Where it was sent and what each committee and subcommittee did with it, in order.
| Chamber | Committee | What it did |
|---|---|---|
| House | Ways and Means Committee | Referred Aug 1, 2017Markup Sep 5, 2018Reported Sep 10, 2018 |
| House | Energy and Commerce Committee | Referred Aug 1, 2017Discharged Sep 10, 2018 |
| Health Subcommittee | Referred Aug 4, 2017 | |
| Senate | Finance Committee | Referred Sep 17, 2018 |
Actions 14
Everything that happened, newest first.
- Sep 17, 2018Received in the Senate and Read twice and referred to the Committee on Finance.
- Sep 12, 2018Ms. Jenkins (KS) moved to suspend the rules and pass the bill, as amended.
- Sep 12, 2018Considered under suspension of the rules. (consideration: CR H8122-8124)
- Sep 12, 2018DEBATE - The House proceeded with forty minutes of debate on H.R. 3635.
- Sep 12, 2018Passed/agreed to in House: On motion to suspend the rules and pass the bill, as amended Agreed to by voice vote. (text: CR H8122-8124)
- Sep 12, 2018Motion to reconsider laid on the table Agreed to without objection.
- Sep 10, 2018Reported (Amended) by the Committee on Ways and Means. H. Rept. 115-933, Part I.
- Sep 10, 2018Committee on Energy and Commerce discharged.
- Sep 10, 2018Placed on the Union Calendar, Calendar No. 724.
- Sep 5, 2018Committee Consideration and Mark-up Session Held.
- Sep 5, 2018Ordered to be Reported in the Nature of a Substitute by Voice Vote.
- Aug 4, 2017Referred to the Subcommittee on Health.
- Aug 1, 2017Introduced in House
- Aug 1, 2017Referred 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.
In the Congressional Record 1
Days the Record’s own index lists this bill, newest first, with the pages and the members it names. Pages starting H are the House, S the Senate, E Extensions of Remarks.
| Where | In the Record | Members | Date |
|---|---|---|---|
| House | Debate and remarks H8122–H8124Text printed H8122 | Lynn Jenkins R-KS, Sander M. Levin D-MI | Sep 12, 2018 |
Research
What has been written about this bill: committee reports, cost estimates, the sponsor’s authority statement, printed hearings and the Congressional Research Service’s work.
Committee report
Congressional Budget Office cost estimate
- Sep 12, 2018H.R. 3635, Local Coverage Determination Clarification Act of 2017As ordered reported by the House Committee on Ways and Means on September 5, 2018
Constitutional authority
The sponsor’s statement, as printed in the Congressional Record, vol. 163, no. 130, August 1, 2017, page H6585.
Related bills 2
Companion bills and other measures the record links to this one.
| Bill | Title | Relationship | Latest action |
|---|---|---|---|
| S 794 | Local Coverage Determination Clarification Act of 2017 | Related bill | Mar 30, 2017 |
| HR 5721 | Local Coverage Determination Clarification Act of 2016 | Reintroduction of | Jul 19, 2016 |
Titles 4
Every title it has carried, official and short, at each stage.
- 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.
- Short Titles as Introduced
- Local Coverage Determination Clarification Act of 2017
- Short Titles as Reported to House
- Local Coverage Determination Clarification Act of 2018
- Short Titles as Passed House
- Local Coverage Determination Clarification Act of 2018
Subjects
Assigned by the Library of Congress. Policy area: Health.
Text 4
Each version as it was printed, newest first.
- Sep 17, 2018Referred in Senate
- Sep 12, 2018Engrossed in House
- Sep 10, 2018Reported in House
- Aug 1, 2017Introduced in House
Everything here is as published by Congress: the summary is the Congressional Research Service's, the action wording is the clerks', and the subjects are the Library of Congress's. How far it got is read from the actions themselves, taking the most recent one of each kind, so a bill that failed a vote and later passed is shown as having passed. Records come from this bill on Congress.gov and govinfo.gov; cost estimates are the Congressional Budget Office's, and the hearings are the printed hearings GovInfo publishes, which can appear months after the hearing.
