Last Modified: 9/10/2020
Location: FL, PR, USVI
Business: Part A, Part B
The local coverage determination (LCD) process may begin with informal meetings in which interested parties in the Medicare administrative contractor’s (MAC’s) jurisdiction can informally discuss potential new LCD requests. These meetings are for educational purposes only and are not pre-decisional negotiations. These meetings are permitted but are not required and the process allows requestors to communicate via conference call or in-person meeting before submitting a formal request. These meetings will assure that all relevant evidence needed for review for coverage is submitted with the request for a formal review. Detailed instructions regarding the LCD development process are found in the Centers for Medicare & Medicaid Services (CMS) internet-only manual (IOM), publication 100-08, Medicare program integrity manual (PIM), chapter 13. The process includes consultations with experts, publication of the proposed policy, opportunity for public comments in writing, publication of a final LCD, response to public comments and notice of the new policy.
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