The Statutory Requirements for Explanation in an NCD; SSA 1862

https://www.ssa.gov/OP_Home/ssact/title18/1862.htm


This text is not clearly numbered but appears just prior to 1862(b).  Congress writes:

"In making a national coverage determination (as defined in paragraph (1)(B) of section 1869(f)) the Secretary shall ensure consistent with subsection (l) that the public is afforded

• notice and opportunity to comment prior to implementation by the Secretary of the determination; 
• meetings of advisory committees with respect to the determination are made on the record; 
• in making the determination, the Secretary has considered applicable information (including clinical experience and medical, technical, and scientific evidence) with respect to the subject matter of the determination; 
• and in the determination, provide a clear statement of the basis for the determination (including responses to comments received from the public), the assumptions underlying that basis, and make available to the public the data (other than proprietary data) considered in making the determination."

Subsection 1862(l) [ el ] defines LCD and NCD processes, while section 1869(f) simple defines LCD and NCD.