In re: LCD Complaint: Computed Tomography Colonography, DAB CR5346 (2019)

DECISION DISMSSING COMPLAINT

By letter dated November 9, 2018, the Civil Remedies Division of the Departmental Appeals Board acknowledged that it had received correspondence, dated October 22, 2018, from a physician.  The physician sought Medicare coverage for a procedure (virtual colonoscopy) that his patient required.  The Civil Remedies Division treated his letter as a request for review of a local coverage determination (LCD) regarding computed tomography colonography.

In an order dated March 7, 2019, I acknowledged receipt of the letter, explained the requirements for filing a valid complaint challenging an LCD, and determined that the physician had not met those requirements.  Indeed, the physician had not alleged that he was an aggrieved party, nor did he demonstrate that he represented an aggrieved party.  Citing the requirements of 42 C.F.R. § 426.410(c)(1), I offered the physician and his patient an opportunity to file an acceptable complaint and directed them to do so no later than April 8, 2019.  Neither has responded to my order.

Because neither the physician nor his patient has, within the timeframe I established, submitted an acceptable amended complaint, I dismiss this action pursuant to 42 C.F.R. § 426.410(c)(2).