The Medicare statute states that items and services provided to beneficiaries must be “reasonable and necessary” to qualify for reimbursement. Although the Medicare program determines in specific cases whether an item or service is reasonable and necessary, it also issues policies, called coverage determinations, to instruct Medicare Administrative Contractors (MACs) what to reimburse providers for….
ACR Supports Bill for Increased Medicare Contractor Transparency
Working with more than 40 other medical associations, the ACR is supporting proposed federal legislation, the Local Coverage Determination Clarification Act of 2017 (S. 794). The bill is co-sponsored by Sens. Johnny Isakson (R-Ga.), Tom Carper (D-Del.), John Boozman (R-Ark.) and Debbie Stabenow (D-Mich.). The bill’s provisions would add transparency to how Medicare Administrative Contractors…