National Coverage Determination Transparency Act (H.R. 5389)

Where This Stands

Introduced

Committee

Floor Vote

Passed

Signed

Currently IN_COMMITTEE. The next step in the legislative lifecycle is Floor Vote.

Version history

Only one version on file - nothing to compare yet. As later stages (committee substitute, engrossed, enrolled) are captured, the redline appears here.

View official text →

The Frame

What this does

This legislation changes the administrative timeline for medical providers and manufacturers seeking Medicare coverage for new technologies, potentially reducing delays in the federal review process by requiring the government to specify missing information and track the full duration of the application process.

Who is mentioned in the record

Potentially affected actors named in the source documents. Mention is not a position.

Medical technology and pharmaceutical companies

These entities must follow new submission guidelines and will receive faster feedback on the completeness of their Medicare coverage requests.

Centers for Medicare & Medicaid Services

The agency is required to implement new 30-day review deadlines, provide technical assistance, and maintain a public website for tracking requests.

What changed

Current stage: IN_COMMITTEE.

What's next

Floor Vote.

Background

Mr. Guthrie and Mr. Kelly are members of the U.S. House of Representatives. context
The Social Security Act is the foundational federal law that established the Medicare program. context

Summary

This bill requires the federal government to provide faster feedback and public updates when companies or organizations request new Medicare coverage determinations. It mandates that the of Health and Human Services notify applicants within 30 days if their request is incomplete and publish all formal requests online within two business days.

Key Facts

You don't have to trust us. Each fact below is taken straight from the official document - click any one to see the exact passage, highlighted in the original.

Why It Matters

This legislation changes the administrative timeline for medical providers and manufacturers seeking Medicare coverage for new technologies, potentially reducing delays in the federal review process by requiring the government to specify missing information and track the full duration of the application process.

Frequently Asked Questions

What is a National Coverage Determination (NCD)?

An NCD is a national policy determination made by the of Health and Human Services regarding whether a specific medical item or service is covered by Medicare.

How does this bill affect companies applying for Medicare coverage?

It forces the government to be more transparent by requiring them to explain why an application is incomplete and to publish accepted applications online quickly.

News Coverage

No news coverage found yet. Articles are indexed twice daily.

Connected Entities

personMr. Guthrie“Introduced the bill”Map →

bill_numberH.R. 5389“Bill number”Map →

dateSeptember 12, 2023“Date the bill was introduced”Map →

organizationCommittee on Energy and Commerce“Referred to the committee”Map →

other78 Fed. Reg. 48164“Federal register”Map →

personMr. Kelly of Pennsylvania“Co-sponsored the bill”Map →

organizationCommittee on Ways and Means“Referred to the committee”Map →

otherMedicare Program; Revised Process for Making National Coverage Determinations“Rule entitled”Map →

organizationCenters for Medicare & Medicaid Services“Responsible for making national coverage determinations”Map →

Analysis Score

0–100

Significance60
How much this matters to a regular citizen
Controversy10
Intensity of disagreement among stakeholders
Entertainment5
Compellingness for a non-policy-wonk reader
Buzz20
Current news / social attention level