Improving Seniors’ Timely Access to Care Act

Skilled Nursing News reported that legislation was recently reintroduced to Congress for the third time last week in hopes of streamlining and improving outdated prior authorization processes for Medicare Advantage (MA).

This bipartisan bill, reintroduced by many lawmakers, including Representative Ami Bera (D-CA), continues to draw widespread backing and support from various lawmakers. The Improving Seniors’ Timely Access to Care Act would require Medicare Advantage (MA) plans to implement an electronic prior authorization system with standardized transactions and improve transparency regarding the use and requirements of MA prior authorization.

The move comes on the heels of the Centers for Medicare & Medicaid Services (CMS) issuing a final rule in April to modernize and improve many Medicare programs, including Medicare Advantage (MA).

“As a doctor, I’ve seen firsthand how the broken prior authorization process delays needed care and frustrates both seniors and their physicians,” Rep. Bera said in a press release. “The [bill] cuts through red tape and makes it easier for seniors on Medicare Advantage to access the treatments and services they need, when they need them. This bipartisan legislation is a common-sense fix that puts patients over paperwork.”

This bill has been endorsed by more than 500 organizations representing patients, providers, medical technology innovators, pharmaceutical companies, and health plans. Mary Beth Donahue, president and CEO of the Better Medicare Alliance, supports the proposed legislation to improve the existing led authorization process and says it’s essential for keeping healthcare costs low, ensuring that seniors receive the most appropriate and adequate care. This
bill would also clarify the authority of the Health and Human Services (HHS) to set timelines for decisions, including real-time timelines for touring cases. It would require other agencies to report on oversight and enhancements to the electronic prior authorization process.