- The Honorable Neal Dunn
466 Cannon House Office Building
Washington, D.C., 20515 - The Honorable Nanette Barragán
2312 Rayburn House Office Building
Washington, D.C., 20515 - The Honorable Claudia Tenney
2230 Rayburn House Office Building
Washington, D.C., 20515
Representative Dunn, Representative Barragán, and Representative Tenney:
We’re writing to thank you for your leadership in introducing H.R. 8500, the Timely Access to Coverage Decisions Act of 2026. This legislation would help to ensure that patients have access to medically necessary items and services by making the local coverage determination (LCD)
process more predictable and meaningful by providing an open, transparent process and improving the Centers for Medicare and Medicaid Services (CMS) oversight of Medicare Administrative Contractors (MACs) coverage policies.
Medicare coverage policy decisions are made nationally and locally. At the local level, LCDs are developed by MACs who determine whether, and under what circumstances, to cover a particular item or service on a contractor-wide basis.
As a result of contracting reforms that have taken place over the years, MACs are responsible for much larger jurisdictions, often with fewer opportunities for stakeholders to interact with the contractor medical directors who make local medical policies. Additionally, while CMS released revisions in 2018 to Medicare’s Program Integrity Manual (PIM), which outlines the rules governing the development of LCDs, the process continues to lack transparency and sufficient stakeholder involvement to ensure that decisions are made in the best interests of patients. Codifying key elements of the PIM would strengthen CMS oversight of the LCD process and help ensure greater transparency, consistency, and accountability across MAC jurisdictions.
Click here to view the full Letter of Support for Timely Access to Coverage Decisions Act of 2026 (HR 8500)
