,i  #aahth ,,congress  #ast ,session    
,h4 ,r4 #ecif  ,,in ,,the ,,house ,,of  
,,representatives  ,september #ab1      
#bjbc,mr4 ,bucshon introduced the       
following bill2 which was referred to   
the ,committee on ,ways and ,means1 and 
in addition to the ,committee on ,energy
 and ,commerce1 for a period to be      
subsequently determined by the ,speaker1
 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 prohibit  
,medicare local coverage determinations 
from restricting access to care1 and for
 other purposes4  #a4 ,short title ,this
 ,act may be cited as the ,coverage     
,determination ,clarity ,act of #bjbc4  
#b4 ,improving access to items and      
services under medicare local coverage  
determinations  7a7 ,in general ,section
 #ahfb7l77#e7 of the ,social ,security  
,act 7#db ,u4,s4,c4 #aciey7l77#e77 is   
amended--  7#a7 in subparagraph 7,a71 by

 striking ,the ,secretary and inserting 
,subject to subparagraph 7,e71 the      
,secretary2 and  7#b7 by adding at the  
end the following new subparagraph3     
7,e7 ,prohibition on limiting access    
items and services  7i7 ,review of local
 coverage determinations ,beginning in  
#bjbd1 and annually thereafter1 the     
,secretary shall review each local      
coverage determination in effect as of  
the date of such review to determine    
whether such local coverage             
determination denies1 limits1 or        
conditions the coverage or provision of 
items or services beyond that provided  
by a national coverage determination    
that has determined that such items or  
services be covered nationally under    
this title4  7ii7 ,conflict between a   
national coverage determination and a   
local coverage determination ,a local   
coverage determination denies1 limits1  
or conditions the coverage or provision 
of items or services for purposes of    
clause 7i7 to the extent that such local

 coverage determination limits access to
 such items or services by imposing     
restrictions that do not directly       
interpret provisions of a national      
coverage determination that has         
determined that such items or services  
be covered nationally under this title4 
7iii7 ,revision of local coverage       
determinations  7,i7 ,in general ,if the
 review conducted by the ,secretary     
under clause 7i7 determines that a local
 coverage determination denies1 limits1 
or conditions the coverage or provision 
of items or services that are approved1 
cleared1 authorized1 or licensed under  
section #eje1 #eaj7k71 #eac1 or #eae of 
the ,federal ,food1 ,drug1 and ,cosmetic
 ,act or section #cea of the ,public    
,health ,service ,act1 the ,secretary   
shall direct the appropriate ,medicare  
administrative contractor to            
expeditiously revise such local coverage
 determination to eliminate the         
limitation4  7,,ii7 ,timing ,a ,medicare
 administrative contractor shall publish

 a revised local determination no later 
than the date that is #ahj days after   
the date on which the ,secretary directs
 such contractor to revise a local      
coverage determination under subclause  
7,i74  7iv7 ,new local coverage         
determinations ,the ,secretary shall    
require each ,medicare administrative   
contractor that develops a local        
coverage determination to ensure that   
any such local coverage determination   
does not deny1 limit1 or condition the  
coverage or provision of items or       
services pursuant to clause 7ii7 beyond 
that provided by a national coverage    
determination that has determined that  
such items or services be covered       
nationally under this title4  7v7 ,error
 verification and corrective actions ,in
 verifying any potential errors and     
taking corrective actions1 ,medicare    
administrative contractors1             
comprehensive error rate testing        
recovery auditors1 and unified program  
integrity contractors and independent   

review agencies--  7,i7 shall not       
deviate from local coverage             
determination provisions applicable in  
the region in which such verification or
 corrective action occurs2 and  7,,ii7  
shall provide transparent review by     
publishing the names of the reviewers   
and their qualifications in a place and 
format available to providers4  7vi7    
,reports to congress ,beginning in #bjbe
 and each year thereafter1 the          
,secretary shall submit a report to the 
appropriate committees of ,congress on  
the findings of the review conducted    
under clause 7i7 and any local coverage 
determinations revised pursuant to      
clause 7iii7 during the preceding year4 
4  7b7 ,effective date ,the amendments  
made by subsection 7a7 shall apply with 
respect to proposed and final local     
coverage determinations posted on       
,medicare administrative contractor     
websites on and after ,january #a1      
#bjbc4