A recent legislative move aims to enhance timely access to healthcare for seniors, as the House Ways and Means Committee unanimously approved the bill on Wednesday, a decision lauded by many health advocates. The bill, titled the Improving Seniors’ Timely Access to Care Act, is designed to reform prior authorization processes within Medicare Advantage plans.<\/p>\n
Representatives Ami Bera (D-CA), Mike Kelly (R-PA), Suzan DelBene (D-WA), and John Joyce (R-PA) introduced the bill, while Senators Roger Marshall (R-KS) and Mark Warner (D-VA) are sponsoring a companion version in the Senate, which has not yet been released from committee.<\/p>\n
The proposed legislation mandates that standard prior authorization requests in Medicare Advantage must be completed within seven days, while urgent requests should be processed within 72 hours. Additionally, it transitions to an electronic prior authorization system and requires plans to publicly disclose prior authorization information. The Centers for Medicare and Medicaid Services (CMS) will also be tasked with real-time assessment of prior authorization processes.<\/p>\n
The committee passed the bill with a unanimous vote of 42-0, advancing it to the House Energy and Commerce Committee for further consideration.<\/p>\n
The American Health Care Association expressed strong support for the measure. Clif Porter, the organization\u2019s CEO, emphasized that the legislation builds on significant progress in holding large Medicare Advantage insurers accountable for their prior authorization practices. “Too many seniors face unnecessary delays in accessing essential post-acute care,” he stated, commending the bipartisan effort to increase transparency and ease the burden of prior authorizations.<\/p>\n
The American Medical Association also reacted favorably to the committee’s approval, asserting that the bill underscores the need to address detrimental delays caused by prior authorizations in healthcare. “Today’s unanimous vote reflects a growing recognition of the fact that misused prior authorization often stands between patients and their physicians,” said Willie Underwood III, the organization’s president. The AMA pledged to collaborate with Congress to ensure the legislation becomes law.<\/p>\n
Additionally, the American Hospital Association voiced its support for the Improving Seniors’ Timely Access to Care Act but urged lawmakers to restore the original deadline of January 1, 2028, for Medicare Advantage plans to implement a standardized electronic prior authorization process, as opposed to the revised deadline of January 1, 2029, included in the committee\u2019s amended version.<\/p>\n
The House Ways and Means Committee also advanced several other health-related bills, such as the Rural Patient Monitoring Access Act, which seeks to improve Medicare reimbursement for remote patient monitoring in rural areas, and the Medicare Rural Anesthesiology Access Act, aimed at expanding anesthesia services in rural hospitals.<\/p>\n
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