U.S. Congress legislation · 119th Congress
SB5475: Timely Access to Coverage Decisions Act
Status: In committee, September 23, 2026
A bill to amend title XVIII of the Social Security Act to ensure timely review of local coverage determination requests under the Medicare program.
What the bill says
To amend title XVIII of the Social Security Act to ensure timely review of local coverage determination requests under the Medicare program.
From the introduced text, September 23, 2026:
A BILL To amend title XVIII of the Social Security Act to ensure timely review of local coverage determination requests under the Medicare program. SECTION 1. Short title This Act may be cited as the Timely Access to Coverage Decisions Act . SECTION 2. Ensuring timely review of local coverage determination requests under the Medicare program (a) In general Section 1862(l)(5) of the Social Security Act ( 42 U.S.C. 1395y(l)(5) ) is amended by adding at the end the following new subparagraph: (E) Timeframe for decisions on requests for local coverage determinations (i) In general The Secretary shall require each Medicare administrative contractor that receives a formal LCD request on or after the date that is 90 days after the date of enactment of this subparagraph to determine whether such request is a complete request or an incomplete request not later than 60 days after such contractor receives such request. (ii) Notification with respect to incomplete requests In the case that a Medicare administrative contractor makes a determination described in clause (i) with respect to a formal LCD request that such request is incomplete, such contractor shall, not later than 60 days after the date on which such contractor received such request, transmit to the entity that submitted such request a written notification of such determination that includes a specification …
Sponsors
- Lujan, Ben Ray (D) · primary sponsor
- Cotton, Tom (R, SD-AR)
Latest actions
- : Read twice and referred to the Committee on Finance.
- : Introduced in Senate
Subjects: Health
Common questions
- What is SB5475?
- SB5475 is a bill in Congress (119th Congress): Timely Access to Coverage Decisions Act.
- What does SB5475 do?
- In its own words: To amend title XVIII of the Social Security Act to ensure timely review of local coverage determination requests under the Medicare program.
- What is the status of SB5475?
- In committee as of September 23, 2026. Latest action: Read twice and referred to the Committee on Finance. (September 23, 2026).
- Who sponsored SB5475?
- Lujan, Ben Ray (D), with 1 co-sponsor.
- Where is the official record for SB5475?
- On the Congress website: https://www.congress.gov/bill/119th-congress/senate-bill/5475
Source: official Congress record. Tracked by Delilah, AI for legislation across all 50 states and Congress.