Last Congress, the House passed the Improving Seniors’ Access to Care Act of 2021 to streamline prior authorization requirements in Medicare Advantage (MA) plans. Despite 326 bipartisan cosponsors in the House and 50 in the Senate, the bill ultimately failed to pass due to its high estimated cost.
Now the good news: U.S. Sens. Sherrod Brown (D-Ohio), Roger Marshall (R-Kan.), Kyrsten Sinema (I-Ariz.) and John Thune (R-S.D.) as well as Reps. Ami Bera (D-Calif.), Larry Bucshon (R-Ind.), Suzan DelBene (D-Wash.) and Mike Kelly (R-Pa.) have introduced the bipartisan and bicameral Improving Seniors’ Timely Access to Care Act of 2024 (S. 4532/H.R. 8702). This updated bill includes changes that reduce the cost of the legislation, while preserving our goal: to reduce the administrative burden and undue delay of patient care imposed by prior authorization in MA plans.
The ACR applauds the reintroduction of this legislation and is asking Congress to pass the Improving Seniors’ Timely Access to Care Act of 2024 to increase transparency and efficiency of prior authorization for MA health plans by:
- Establishing an electronic prior authorization program in MA plans;
- Requiring MA plans to report prior authorization criteria and usage;
- Clarifying the authority of the Centers for Medicare & Medicaid Services (CMS) to define a process for real-time decisions for routinely approved items and services;
- Allowing the Department of Health & Human Services (HHS) to establish timeframe requirements for MA plans to respond to different types of prior authorization requests; and
- Expanding beneficiary protections to improve enrollee experiences and outcomes.
Act now to urge your lawmakers to support the rheumatology care community and the patients you serve. The ACR’s Legislative Action Center will allow you to contact your members of Congress with just a few clicks. Take a moment to send your letter today!
