The US Oncology Network Supports Local Coverage Determination Clarification Act

The US Oncology Network sent a letter to Congresswoman Lynn Jenkins (R-KS) and Congressman Ron Kind (D-WI) expressing support for the Local Coverage Determination Clarification Act (H.R. 5721), legislation that changes the process Medicare Administrative Contractors (MACs) use to make local coverage decisions that can limit or deny patients’ access to care.

Specifically, the bill would:

  • require MACs to disclose the rationale for an LCD and the evidence upon which they relied at the outset of the LCD process rather than when the LCD is finalized;
  • provide interested parties with a meaningful reconsideration process outside of the of the MAC that finalized the LCD;
  • eliminate backdoor National Coverage Decisions by prohibiting MACs from adopting an LCD from another jurisdiction without first conducting its own independent evaluation of the evidence; and
  • require Medicare Administrative Contractors (MACs) to have open and public Carrier Advisory Committee meetings that are on the record.

The Network also joined the Advanced Medical Technology Association (AdvaMed), American Society of Clinical Oncology (ASCO), American Society for Radiation Oncology (ASTRO), Amputee Coalition, and College of American Pathologists in urging lawmakers to cosponsor the legislation to improve Medicare’s coverage process and ensure that patients can benefit from medical innovation.

To read the USON letter to Representatives Jenkins and Kind, CLICK HERE.

To read the group letter on H.R. 5721, CLICK HERE.

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