Sponsors of a bill reforming the Medicare Advantage prior authorization process said the legislation is "one step closer to becoming law" after CMS released a proposed prior authorization improvement rule Dec. 6.
The bill — the Improving Seniors' Timely Access to Care Act — would, among other actions, establish an electronic prior authorization process and require Medicare Advantage plans to report to CMS the extent of their use of prior authorization and the rate of approvals or denials. It would also require HHS to develop a process for "real-time decisions" on items and services that are routinely approved. The House's version of the bill passed unanimously in September and the Senate version remains under consideration. Here are what two of the sponsors said following the release of CMS' proposed rule:
Kansas Sen. Roger Marshall: The massive support for this legislation from Republicans and Democrats in both chambers of Congress, plus the more than 500 groups that have endorsed it, and now the CMS proposed rule, are all proof that this is truly a good faith effort to make health care better for America’s seniors. Modernizing Medicare Advantage is the number one administrative hurdle for physicians and I can personally speak to these challenges as a physician myself and from my time managing Great Bend Regional Hospital. There's a reason why the Improving Seniors' Timely Access to Care Act is one of the most popular bills this Congress. I'm grateful for all the hard work that has gone into creating significant momentum for this bill, for it is this hard work that brings us closer to getting this over the finish line before the new Congress.
Washington Rep. Suzan DelBene: Seniors and their families should be focused on getting the care they need, not insurance paperwork. I welcome the proposed prior authorization rule from CMS as one more step toward bringing this process into the 21st century and improving the health of our seniors. We cannot stop here. We need to get the bipartisan, bicameral Improving Seniors' Timely Access to Care Act through the Senate and to President Biden's desk before the end of the year.
Read comments from all of the bill's lead sponsors here.