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[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 8849 Introduced in House (IH)]

<DOC>

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.

_______________________________________________________________________

                    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

_______________________________________________________________________

                                 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.
                                 <all>
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