On Wednesday, July 27, the U.S. House Ways and Means Committee unanimously passed the Improving Seniors’ Timely Access to Care Act. This bill reforms the burdensome prior authorization process under Medicare Advantage (MA) plans. The committee’s action is a key step toward getting this legislation enacted this year.
The bill would protect patients from unnecessary prior authorization practices that limit their timely access to medically necessary care. Specifically, the Act would:
- Establish an electronic prior authorization process,
- Minimize the use of prior authorization for services that are routinely approved,
- Ensure prior authorization requests are reviewed by qualified medical personnel,
- Require plans to report on the extent of their use of prior authorization and the rate of delays and denials, and
- Ensure that plans adhere to evidence-based medicine guidelines.
Rep. Greg Murphy, MD, member of the Ways and Means Committee, offered compelling testimony during the committee’s hearing which can be accessed at: VIDEO LINK.
Rep. Greg Murphy, MD testifies during the July 27, 2022
hearing of the US House Ways and Means Committee
While the bipartisan measure would help protect patients from unnecessary delays in care by streamlining and standardizing prior authorization under the Medicare Advantage program, it would also pave the way for prior authorization reforms to other public and private plans.
This pending legislation has been a focus of our congressional advocacy efforts in recent years. Thanks to those who have reached out to members of Congress to encourage their support for this bill. Outreach to our state and federal legislators makes a difference, so if you have not signed up to be a Key Contact, please join your colleagues as advocacy partners.