# 119-s-5475: Timely Access to Coverage Decisions Act

119-s-5475, Timely Access to Coverage Decisions Act, is a 119th Congress bill sponsored by Sen. Luján, Ben Ray [D-NM] (D-NM); status introduced; PRIA reads it as touching household money (as of 2026-10-17).

- Canonical: https://policyrisk.com/legislation/119-s-5475
- As of: 2026-10-17
- Plain-text twin of the page above; the HTML and this file carry the same facts.

## Facts
- Bill: 119-s-5475
- Congress: 119
- Title: Timely Access to Coverage Decisions Act
- Status: introduced
- Introduced: 2026-09-23
- Sponsor: Sen. Luján, Ben Ray [D-NM] (D-NM)
- Cosponsors: 1
- Policy area: Health
- Touches household money: yes
- Last recorded action: 2026-10-17

## Summary

**The Timely Access to Coverage Decisions Act would require new deadlines, public drafts, expert input, and a review path so Medicare local coverage determinations are more timely and transparent.** It focuses on structured development, set timelines for requests and reconsiderations, and a Secretary review option for disputed final decisions. - Medicare beneficiaries: Would get clearer notice and more opportunity to weigh in because draft local coverage determinations must be published with rationale and evidence and include public meetings and a comment period. - Providers and suppliers: Would face a formal request and reconsideration process that sets a 60‑day completeness check and requires substantive action within 1 year after a complete request. These steps apply to requests received after specified post‑enactment windows. - Medicare administrative contractors and stakeholders: Would need to run open meetings, assemble expert panels, post meeting records within 14 days, allow at least a 30‑day public comment period, and delay final rules at least 45 days after posting.

## Cosponsors (1)

- Sen. Cotton, Tom [R-AR] (R-AR), 2026-09-23T00:00:00.000Z

## Provisions PRIA read

- Faster decisions for Medicare coverage requests: benefit, low. If enacted, Medicare contractors would have 60 days to decide whether a formal local coverage determination or formal reconsideration request is complete. These completeness rules would apply to requests received on or after 90 days after enactment. If a request is incomplete, the contractor would…
- More public and Secretary review of Medicare rules: benefit, low. If enacted, contractors would have to post drafts of certain local coverage decisions on the Medicare Coverage Database with coding guidance, a written rationale, and evidence. Within 60 days of posting a draft they would hold public meetings, post agendas at least 14 days beforehand, and post meet…

## Related bills

- 119-s-2120: Older Americans Act Reauthorization Act of 2025
- 119-s-4668: Protect College Sports Act of 2026
- 119-s-2342: Intelligence Authorization Act for Fiscal Year 2026
- 119-s-5022: Cannabis Administration and Opportunity Act
- 119-s-2819: Head Start for America's Children Act
- 119-s-1748: Kids Online Safety Act

## Sources
- [119-s-5475 on Congress.gov](https://www.congress.gov/bill/119th-congress/senate-bill/5475)

## Related
- [119-s-2120: Older Americans Act Reauthorization Act of 2025](https://policyrisk.com/legislation/119-s-2120)
- [119-s-4668: Protect College Sports Act of 2026](https://policyrisk.com/legislation/119-s-4668)
- [119-s-2342: Intelligence Authorization Act for Fiscal Year 2026](https://policyrisk.com/legislation/119-s-2342)
- [119-s-5022: Cannabis Administration and Opportunity Act](https://policyrisk.com/legislation/119-s-5022)
- [119-s-2819: Head Start for America's Children Act](https://policyrisk.com/legislation/119-s-2819)
- [119-s-1748: Kids Online Safety Act](https://policyrisk.com/legislation/119-s-1748)
- [All bills in Congress](https://policyrisk.com/legislation)

Source: PRIA, https://policyrisk.com/legislation/119-s-5475 (as of 2026-10-17).