Joco Today

U.S. Senator Roger Marshall, M.D., recently participated in the Senate Budget Committee hearing on Reducing Paperwork, Cutting Costs: Alleviating Administrative Burdens in Health Care. During the hearing, he stressed the need to reform prior authorization for hospitals and physicians nationwide. He shared his personal experiences as a practicing physician and highlighted how prior authorization can compromise patient care.

Senator Marshall also drew attention to the Improving Seniors’ Timely Access to Care Act, a bipartisan piece of legislation he believes will prioritize patients over paperwork. The senator and his colleagues have been addressing Congressional Budget Office (CBO) scoring issues by successfully advocating for the Centers for Medicare and Medicaid Services (CMS) to implement significant provisions of their bill.

The senator announced that the bipartisan group plans to reintroduce their updated bill next month. This move aims to implement further changes and solidify their victory with CMS.

In his remarks, Senator Marshall stated, “I think I want to start just describing that I’ve lived this nightmare – as a practicing physician for 25 years, running a private OB/GYN practice. And then additionally, running a private hospital as well, this issue of prior authorization is the number one administrative burden for physicians, but it’s also disruptive to the hospital."

He continued by sharing an anecdote about an ice storm that resulted in multiple emergency admissions at his hospital. However, due to lack of prior authorization, they were unable to proceed with critical surgeries. He emphasized that such situations are not isolated incidents but rather common occurrences where insurance companies use this process to ration care.

Despite these challenges, Senator Marshall remains optimistic about their upcoming bill—the Improving Seniors’ Timely Access to Care Act—scheduled for reintroduction in June. The proposed legislation aims to streamline and standardize the process for prior authorization.

“What this bill does, among other things, is it guardrails, streamlines, and standardizes the process for prior authorization. This prior authorization reporting requirement in our bill is the RX to cut down on waste, fraud, and abuse," he said.

The senator noted that the legislation has already garnered significant support, with 53 Senate cosponsors, 10 Senators on this committee, 326 House members, and 550 outside organizations backing it. Furthermore, it now has a zero CBO score.

Senator Marshall concluded his remarks by urging both minority and majority staff that there should be no reason why everyone on Budget, HELP, and Finance Committee shouldn't cosponsor this bill and pass it with unanimous consent.