In re LCD Complaint: Non-covered Services, DAB CR5529 (2020)

DECISION DISMISSING COMPLAINT

In an acknowledgment dated December 11, 2019, the Civil Remedies Division of the Departmental Appeals Board acknowledged that it had received correspondence, dated November 11, 2019, from an aggrieved party.  She sought Medicare coverage for blood tests (apolipoprotein levels) that, in her 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 December 11 acknowledgment, I explained the requirements for filing a valid complaint challenging an LCD, and determined that the aggrieved party’s submission had not met those requirements.  Citing the requirements of 42 C.F.R. § 426.410(c)(1), I offered the aggrieved party an opportunity to file an acceptable complaint and directed her to do so no later than January 10, 2020.  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).