Urge Your Members of Congress to Reduce Prior Authorization Burdens in Medicare Advantage
In the 117th Congress (2021-2022), the Improving Seniors’ Timely Access to Care Act was one of the most heavily cosponsored healthcare bills in Congress. It garnered more than 375 bipartisan cosponsors and endorsements from 500+ organizations. While it passed the House of Representatives, it stalled in the Senate. This was largely due to the cost of implementing the policies in that version of the bill.
On June 12, 2024, a modified version of the legislation (S. 4532 /H.R. 8702) was reintroduced which does not have a fiscal impact on the federal budget. Importantly, key provisions that would streamline prior authorizations in Medicare Advantage plans still remain!
Specifically, this bill would:
- Require payers to allow for electronic submission of prior authorization requests and responses.
- Shorten the timeframe for prior authorization determination – 72 hours for urgent requests and 7 calendar days for non-urgent requests.
- Require greater transparency from payers about what services are subject to prior authorization, statistics on their approvals and denials, and how they came to their decisions.
- Require the Centers for Medicare & Medicaid Services to submit a report on the possibility of implementing “real-time” decisions – which could exponentially streamline the process.
This bill represents a significant step toward reigning in burdensome prior authorizations and ensuring patients have timely access to care.
Contact your members of Congress today and urge them to co-sponsor the Improving Seniors’ Timely Access to Care Act (S. 4532 / H.R. 8702) today!
Urge Your Members of Congress to Reduce Prior Authorization Burdens in Medicare Advantage
In the 117th Congress (2021-2022), the Improving Seniors’ Timely Access to Care Act was one of the most heavily cosponsored healthcare bills in Congress. It garnered more than 375 bipartisan cosponsors and endorsements from 500+ organizations. While it passed the House of Representatives, it stalled in the Senate. This was largely due to the cost of implementing the policies in that version of the bill.
On June 12, 2024, a modified version of the legislation (S. 4532 /H.R. 8702) was reintroduced which does not have a fiscal impact on the federal budget. Importantly, key provisions that would streamline prior authorizations in Medicare Advantage plans still remain!
Specifically, this bill would:
- Require payers to allow for electronic submission of prior authorization requests and responses.
- Shorten the timeframe for prior authorization determination – 72 hours for urgent requests and 7 calendar days for non-urgent requests.
- Require greater transparency from payers about what services are subject to prior authorization, statistics on their approvals and denials, and how they came to their decisions.
- Require the Centers for Medicare & Medicaid Services to submit a report on the possibility of implementing “real-time” decisions – which could exponentially streamline the process.
This bill represents a significant step toward reigning in burdensome prior authorizations and ensuring patients have timely access to care.
Contact your members of Congress today and urge them to co-sponsor the Improving Seniors’ Timely Access to Care Act (S. 4532 / H.R. 8702) today!