H.R. 8500 — Timely Access to Coverage Decisions Act of 2026

This section requires Medicare Administrative Contractors (MACs), for formal local coverage determination (LCD) requests and formal reconsideration requests received on or after 90 days after enactment, to determine within 60 days whether each is complete or incomplete, to notify submitters within 60 days of any deficiencies if incomplete, and to issue decisions on complete requests within one year (taking actions specified in existing subparagraph (D)). (LCDs are determinations by MACs on whether items or services are reasonable and necessary for Medicare coverage under SSA §1862(a)(1)(A) in a contractor's geographic jurisdiction.) It further establishes Secretary review, upon request by an interested party (i.e., Medicare beneficiaries, providers/suppliers in the area, or other designated entities), of MAC reconsideration decisions for specified errors (e.g., misapplication of evidence, exceeding scope, inconsistency with national coverage determinations). This section also revises the process for issuing specified LCDs.