New U.S. legislation aims to speed up Medicare coverage decisions

New U.S. legislation aims to speed up Medicare coverage decisions

Updated at: June 5, 2026 at 01:00 AM

In early 2026, U.S. health agencies and lawmakers launched a major effort to reduce delays in Medicare coverage.

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Historically, patients often faced a long wait for new medical devices to be covered after FDA approval.

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To bridge this gap, the Centers for Medicare & Medicaid Services and the FDA introduced the RAPID pathway.

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By aligning evidence requirements during clinical development, RAPID aims to shorten the coverage timeline for breakthrough devices to just 60 to 90 days.

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Beyond administrative changes, Congress is tackling systemic bottlenecks through new legislation.

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The Medicare Advantage Improvement Act of 2026 seeks to shorten prior authorization times to as little as 24 hours for expedited requests and limits the use of automated denial algorithms.

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Meanwhile, the Timely Access to Coverage Decisions Act addresses regional variations by setting strict deadlines for Local Coverage Determinations.

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While the industry largely welcomes these changes as a way to provide faster patient access to life-saving technology, some experts urge caution.

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You read 8 focus sentences.

Challenge Mode

Comprehension Questions

What is the primary objective of the RAPID pathway?

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Correct Choice

To reduce the time gap between FDA approval and Medicare coverage.

How long might the RAPID pathway take to provide coverage after FDA approval?

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Correct Choice

60 to 90 days.

What does the Medicare Advantage Improvement Act of 2026 propose regarding prior authorization?

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Correct Choice

It reduces the timeline for standard decisions to 72 hours and expedited decisions to 24 hours.

What is one criticism mentioned regarding rapid coverage pathways?

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Correct Choice

They might bypass rigorous, evidence-based safety evaluations.

What do the proposed changes to Local Coverage Determinations (LCDs) aim to achieve?

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Correct Choice

To establish enforceable timelines and improve transparency in the decision process.

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New U.S. legislation aims to speed up Medicare coverage decisions | Ringoo