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Committee on Ways and Means 

For Immediate Release
Contact: Press Office 202-225-8933
September 30, 2002

Bipartisan Lawmakers Express Concern about Proposed Regulation on Medicare Coverage Appeals

WASHINGTON - The bipartisan Ways and Means leaders on health expressed their concern Friday that an Administration proposal would prevent decisions of Medicare coverage appeals from being applied to all beneficiaries, and that the proposed regulation contravenes Congressional intent in a 2000 law.

In the letter sent jointly to U.S. Health and Human Services (HHS) Secretary Tommy Thompson and Centers for Medicare and Medicaid Services (CMS) Administrator Tom Scully, lawmakers wrote “the whole point of the Benefit Improvement and Protection Act [of 2000] coverage provisions was to have a successful appeal by a single beneficiary create policy for others, much like Supreme Court rulings become the new law of the land.”

Under the proposed regulation, a beneficiary individually has gained the right to go through the existing claims adjudication process and reap the benefits of a decision, but that decision will not be applied nationally to the remaining 39 million Medicare beneficiaries. Seniors deserve a Medicare National Coverage policy that responds to all seniors with similar conditions when it is proven that a coverage decision adversely affecting them is unscientific and unfair.

The letter is signed by Ways and Means Chairman Bill Thomas (R-CA), Health Subcommittee Chairman Nancy Johnson (R-CT), Ways and Means Ranking Member Charles Rangel (D-NY) and Health Subcommittee Ranking Member Pete Stark (D-CA). Click on the link for a copy of the letter.


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