Here are what leaders of five organizations said following the House of Representatives' unanimous passage Sept. 14 of a bill to reform the Medicare Advantage prior authorization process.
Stacey Hughes. Vice President, American Hospital Association: This legislation takes important steps to reduce the burden and complexity of prior authorization requirements imposed by Medicare Advantage plans. These provisions will help Medicare patients access the care they need in a timely manner while reducing the strain on our already taxed healthcare workforce. The AHA is encouraged by Senate support on companion legislation and urges them to take action on these critical protections.
Jack Resneck Jr., MD. President, American Medical Association: The House recognized that prior authorization is an insurance companies practice that is overused, costly, opaque, burdensome to physicians and harmful to patients due to delays in care. The American Medical Association is committed to fixing prior authorization and made doing so a central plank of our Recovery Plan for America’s Physicians. Now that the House has passed this legislation, we urge the Senate to do likewise. There is a Senate companion bill that also has bipartisan support. While healthcare legislation often divides Congress, here is a bipartisan way to improve patient health. The tea leaves suggest this can get done this year.
Mary Beth Donahue. President and CEO, Better Medicare Alliance: Importantly, this bill builds on efforts already underway in Medicare Advantage to modernize prior authorization while protecting its essential function in facilitating safe, high-value, evidence-based care.
Robert Wailes, MD. President, California Medical Association: CMA applauds the bipartisan support for this important legislation, which will ensure that quality patient care remains the top priority — not the corporate bottom line. Insurance company prior authorization red tape undermines healthcare outcomes by placing unnecessary obstacles to patients getting the care they need, when they need it.
Anders Gilberg. Senior Vice President of Government Affairs, Medical Group Management Association: This legislation would lessen administrative burden for medical groups by moving the prior authorization process into the 21st century. The transparency provisions included in this legislation — requiring [Medicare Advantage] plans to publicly reveal what services are subject to prior authorization, how many are approved, and how long on average they take to approve — will drive plan accountability. By streamlining and standardizing the overly cumbersome and wildly inefficient [Medicare Advantage] prior authorization process, this legislation will return a focus to the physician-patient relationship and prevent dangerous delays to timely care.