Joco Today

U.S. Senator Roger Marshall has announced that the Improving Seniors’ Timely Access to Care Act has garnered support from over 500 healthcare and patient advocacy organizations. This bipartisan, bicameral legislation aims to expedite access to quality care for seniors by streamlining the prior authorization process under Medicare Advantage.

Senator Marshall stated, "Our bipartisan, Improving Seniors’ Timely Access to Care Act legislation cuts out burdensome prior authorization forms and pulls back the curtain on the process so physicians can focus on what they love most: delivering quality care to their patients." He added, "With over 500 patient and provider advocacy groups supporting our legislation, we know we are over the target with a solution that can and will improve patient outcomes. Physicians want to focus on patient care over paperwork; it’s that simple."

The bill enjoys significant backing in Congress, with 60 cosponsors in the Senate and 230 in the House of Representatives. It previously passed unanimously in the House during the last Congress.

Prior authorization is intended to prevent unnecessary medical services by requiring pre-approval from health plans. However, this system often leads to delays due to unconfirmed faxes or phone calls about patients' medical information, diverting time away from direct patient care. It remains a major administrative burden for healthcare providers, affecting three out of four Medicare Advantage enrollees with unnecessary delays.

The Office of Inspector General at the U.S. Department of Health and Human Services (HHS) has raised concerns about this process after audits showed that Medicare Advantage plans approved 75% of initially denied requests. Additionally, HHS OIG reported that some denials were incorrect despite meeting Medicare coverage rules.

There is consensus among health plans, providers, and patients that improvements are needed in the prior authorization process to enhance service delivery and reduce administrative burdens on clinicians.