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Coverage Determination Clarity Act of 2023
1/6/2025, 11:41 PM
Summary of Bill HR 5396
Bill 118 HR 5396, also known as the Coverage Determination Clarity Act of 2023, aims to improve transparency and clarity in the process of determining coverage for healthcare services. The bill focuses on ensuring that patients and healthcare providers have a clear understanding of how coverage decisions are made by insurance companies.
One key provision of the bill is the requirement for insurance companies to provide detailed explanations of coverage determinations to patients and healthcare providers. This includes information on the criteria used to make coverage decisions, as well as any appeals process available to challenge a denial of coverage.
Additionally, the bill seeks to standardize the process for coverage determinations across different insurance plans, making it easier for patients and providers to navigate the complex world of healthcare coverage. This standardization would help to reduce confusion and ensure that coverage decisions are made fairly and consistently. Overall, the Coverage Determination Clarity Act of 2023 aims to empower patients and healthcare providers by providing them with the information they need to understand and challenge coverage decisions. By promoting transparency and standardization in the coverage determination process, the bill seeks to improve access to healthcare services for all Americans.
One key provision of the bill is the requirement for insurance companies to provide detailed explanations of coverage determinations to patients and healthcare providers. This includes information on the criteria used to make coverage decisions, as well as any appeals process available to challenge a denial of coverage.
Additionally, the bill seeks to standardize the process for coverage determinations across different insurance plans, making it easier for patients and providers to navigate the complex world of healthcare coverage. This standardization would help to reduce confusion and ensure that coverage decisions are made fairly and consistently. Overall, the Coverage Determination Clarity Act of 2023 aims to empower patients and healthcare providers by providing them with the information they need to understand and challenge coverage decisions. By promoting transparency and standardization in the coverage determination process, the bill seeks to improve access to healthcare services for all Americans.
Read the Full Bill
Current Status of Bill HR 5396
Bill HR 5396 is currently in the status of Bill Introduced since September 12, 2023. Bill HR 5396 was introduced during Congress 118 and was introduced to the House on September 12, 2023. Bill HR 5396's most recent activity was Referred to the Subcommittee on Health. as of December 17, 2024
Bipartisan Support of Bill HR 5396
Total Number of Sponsors
7Democrat Sponsors
0Republican Sponsors
7Unaffiliated Sponsors
0Total Number of Cosponsors
0Democrat Cosponsors
0Republican Cosponsors
0Unaffiliated Cosponsors
0Policy Area and Potential Impact of Bill HR 5396
Primary Policy Focus
HealthAlternate Title(s) of Bill HR 5396
Coverage Determination Clarity Act of 2023
Coverage Determination Clarity Act of 2023
To amend title XVIII of the Social Security Act to prohibit Medicare local coverage determinations from restricting access to care, and for other purposes.
Comments
Ephraim Wolf
762
1 year ago
I think this new bill is good for everyone because it helps make things clearer for people. It says that insurance companies have to explain better how they decide what medical treatments they will cover. This means less confusion for us all. I'm happy that this bill is looking out for us and making things easier to understand. Everyone benefits from this bill because it helps us all get the care we need.
Declan Bowden
810
1 year ago
This bill gonna mess up my healthcare, how will it affect my wallet?
Sponsors and Cosponsors of HR 5396
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