ADLM recently joined a broad coalition of healthcare organizations endorsing H.R. 8500, the Timely Access to Coverage Decisions Act of 2026. The legislation seeks to improve the process used by Medicare Administrative Contractors (MACs) to develop Local Coverage Determinations (LCDs), which establish whether, and under what circumstances, Medicare will cover certain items and services. ADLM and the other signatories emphasized that patients benefit when coverage decisions are made through a transparent, predictable, and evidence-based process.
ADLM noted that changes to the Medicare contracting system have resulted in larger contractor jurisdictions and fewer opportunities for stakeholders to engage directly with the medical directors responsible for developing local coverage policies. While CMS updated guidance governing LCD development in 2018, the association believes the process still lacks sufficient transparency and stakeholder involvement to ensure decisions are made in patients’ best interests.
The bill would establish defined timelines for both initial LCD requests and reconsiderations, require open public meetings with advance notice, incorporate input from physicians, patients, and industry stakeholders, and ensure that meeting records are publicly available before the close of comment periods. The legislation would also create a pathway for stakeholders to appeal final LCDs to CMS after completing review through the contractor process.
ADLM supports efforts to make Medicare coverage decisions more open, predictable, and accountable. The association believes that timely, evidence-based coverage policies are essential to maintaining patient access to medically necessary services and will continue advocating for reforms that improve transparency and stakeholder engagement in Medicare decision-making.