,i  #aahth ,,congress  #b;d ,session    
,h4 ,r4 #hhdi  ,,in ,,the ,,house ,,of  
,,representatives  ,june #bf1 #bjbd,mr4 
,smucker 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 improve the national  
and local coverage determination        
processes under the ,medicare program4  
#a4 ,short title ,this ,act may be cited
 as the ,timeline ,integrity for        
,medicare ,evidence ,development ,act of
 #bjbd or the ,,timed ,act of #bjbd4    
#b4 ,improving the national and local   
coverage determination processes under  
the ,medicare program  7a7 ,in general  
,section #ahfb7l7 of the ,social        
,security ,act 7#db ,u4,s4,c4 #aciey7l77

 is amended by adding at the end the    
following new paragraph3  7#g7          
,limitation on duration of coverage with
 evidence development determinations    
7,a7 ,in general ,subject to            
subparagraph 7,b71 in the case of a     
final decision under paragraph          
7#c77;,c77i7 7including any such        
decision made on a class-wide basis7    
made on or after the date of the        
enactment of this paragraph that results
 in coverage of an item or service      
pursuant to subsection 7a77#a77;,e71 the
 ,secretary shall1 not later than #aj   
years after the date on which such      
coverage becomes effective pursuant to  
such subsection1 initiate a             
redetermination with respect to such    
item or service4  7,b7 ,exception ,the  
,secretary may delay a redetermination  
described in subparagraph 7,a7 with     
respect to an item or service for a     
period of time determined appropriate by
 the ,secretary if-- 7i7 the ,secretary 
finds that such item or service is      

reasonable and necessary to carry out   
the purposes described in section #aadb2
 or  7ii7 the entity responsible for    
such item or service requests such      
extension4  7,c7 ,posting of information
 ,not later than #a year after the date 
of the enactment of this paragraph1 and 
annually thereafter1 the ,secretary post
 on the public website of the ,centers  
for ,medicare  ,medicaid ,services the  
following information3 7i7 ,the number  
of items and services covered under this
 title pursuant to subsection           
7a77#a77;,e74  7ii7 ,a description of   
each such item or service4  7iii7 ,the  
year in which coverage of each such item
 or service became effective pursuant to
 such subsection4  4  7b7 ,provision of 
explanation in case of certain rejected 
requests ,section #ahfb7l7 of the       
,social ,security ,act 7#db ,u4,s4,c4   
#aciey7l771 as amended by subsection    
7a71 is further amended by adding at the
 end the following new paragraph3  7#h7 
,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
 #a year after the date of the enactment
 of this paragraph that identifies      
itself as a complete1 formal request for
 a national coverage determination 7as  
described in the notice entitled        
,medicare ,program2 ,revised ,process   
for ,making ,national ,coverage         
,determinations 7#gh ,fed4 ,reg4 #dhafd7
 or a successor regulation71 the        
,secretary shall1 not later than #ij    
days after receipt of such document--   
7,a7 determine whether such document is 
a complete1 formal request for a        
national coverage determination2 and    
7,b7 in the case that the ,secretary    
finds that such document is not a       
complete1 formal request for a national 
coverage determination1 transmit to the 
entity submitting such document         
information on such finding that        
includes a specification of additional  
information needed to make such document

 a complete1 formal request for a       
national coverage determination4  4  7c7
 ,improving access to items and services
 under local coverage determinations    
,section #ahfb7l77#e7 of the ,social    
,security ,act 7#db ,u4,s4,c4           
#aciey7l77#e77 is amended by adding at  
the end the following new subparagraph3 
7,e7 ,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 law1 ruling1 
regulation1 national coverage           
determination1 payment policy1 or coding
 policy4  4  7d7 ,funding ,there are    
authorized to be appropriated #a1jjj1jjj
 for fiscal year #bjbd for purposes of  
carrying out the amendments made by this
 section4