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This bill establishes a four-year Medicare demonstration program in which medical services and items are automatically deemed medically necessary if they meet specified criteria, including being covered by a significant number of private health plans in the same state or region and being safe and effective. The Secretary of Health and Human Services would select at least 5 states (or 3 Medicare administrative contractor jurisdictions) to participate, and may expand the program during its duration. The program would change how Medicare determines coverage eligibility for certain treatments by aligning Medicare's standards more closely with private insurance coverage patterns.
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