In re LCD Complaint: Non-covered Services, DAB CR5425 (2019)

DECISION DISMSSING COMPLAINT

In an acknowledgment dated August 2, 2019, the Civil Remedies Division of the Departmental Appeals Board acknowledged that it had received correspondence, dated July 17, 2019, from an aggrieved party and from her physician. They sought Medicare coverage for blood tests (hemoglobin A1C; clotting time; coagulation assessment) that, in the physician's view, the aggrieved party (his patient) required. The Civil Remedies Division treated the aggrieved party's letter as a request for review of a local coverage determination (LCD).

In the August 2 acknowledgment, I explained the requirements for filing a valid complaint challenging an LCD, and determined that the beneficiary's submission had not met those requirements. Citing the requirements of 42 C.F.R. § 426.410(c)(1), I offered the beneficiary an opportunity to file an acceptable complaint and directed her to do so no later than September 3, 2019. She has not responded to my order.

Because the aggrieved party has not, within the timeframe I established, submitted an acceptable amended complaint, I dismiss this action pursuant to 42 C.F.R. § 426.410(c)(2).