Joco Today

U.S. Senators Roger Marshall (R-KS), Kyrsten Sinema (I-AZ), John Thune (R-SD), Sherrod Brown (D-OH), and U.S. Representatives Mike Kelly (R-PA), Suzan DelBene (D-WA), Larry Bucshon (R-IN) and Ami Bera (D-CA) have reintroduced the Improving Seniors’ Timely Access to Care Act. This bipartisan, bicameral legislation aims to streamline the prior authorization process under Medicare Advantage, facilitating timely care for seniors and reducing administrative burdens on healthcare providers.

"Prior authorization is the number one administrative burden facing physicians today across all specialties," said Senator Marshall. "As a physician, I understand the frustration this arbitrary process is causing health care practices across the country and the headaches it creates for our nurses."

Senator Sinema highlighted the benefits for Arizona seniors: "We’re improving the authorization process so Arizona seniors with Medicare Advantage plans can receive timely and quality care, while lowering costs and avoiding poorer clinical outcomes related to delayed care."

Senator Thune emphasized efficiency: "Modernizing and streamlining the prior authorization process is critical for South Dakota seniors and providers. This bipartisan legislation would remove unnecessary red tape, make health care more efficient, and ensure patients can access care when they need it."

Senator Brown pointed out current delays: "Right now, too many older Americans enrolled in Medicare Advantage are forced to deal with unnecessary delays when seeking out medical treatment. We need to update the Medicare Advantage program so it works better, faster, and is more transparent for patients and providers."

Congressman Kelly noted widespread support: "With over 33 million Americans enrolled in Medicare Advantage, modernization of the prior authorization process is long overdue. Lawmakers on both sides of the aisle agree – streamlining this process will allow our Nation’s seniors to receive care more efficiently."

Congresswoman DelBene called for legislative action: "We’ve made important incremental headway in helping seniors get the medical care they deserve with the administration’s prior authorization regulations. However, we must go further and enshrine these advancements into law."

Congressman Bucshon added his perspective as a physician: "An inefficient prior authorization process creates unnecessary paperwork, lag time, and hassle for doctors which can delay critical or life-saving procedures for patients."

Congressman Bera emphasized reducing delays: "I am pleased to introduce this bipartisan legislation that will codify protections to help seniors access medical care without unnecessary delays due to prior authorization."

The bill had previously passed unanimously in the House during the last Congress. It enjoys broad support from various national organizations representing patients, physicians, MA plans, hospitals, among others.

The proposed legislation addresses concerns about inefficiencies in current prior authorization processes that often lead to significant delays in patient care. A report by HHS OIG found that MA plans incorrectly denied beneficiaries' access to services despite meeting Medicare coverage rules.

For further details on specific provisions of the bill or supporting documents:

Bill text is available here.

A section-by-section summary can be found here.