Timely Access to Coverage Decisions Act of 2026

Faster, clearer Medicare coverage decisions

If enacted, this bill would speed and make Medicare local coverage decisions more transparent. The rules would take effect 1 year after enactment. For formal LCD and formal reconsideration requests filed on or after 90 days after enactment, a Medicare contractor would have 60 days to say whether the filing is complete and to list any missing information in writing. If a request is complete, the contractor would finish the LCD steps within 1 year, including posting a draft with coding and rationale, holding public meetings within 60 days, posting meeting records within 14 days, and running at least a 30‑day public comment period. Before a final local coverage determination could take effect, the contractor would have to post responses to comments, the full text of comments, the final rationale, any qualifying evidence not previously described, and set an effective date at least 45 days after posting. An interested party (a Medicare beneficiary in the area, a provider or supplier in the area, or an entity the Secretary names) could ask the Secretary to review a final reconsideration decision for errors in evidence use, scope, reasonableness/necessity findings, or conflicts with law.