Legislation addressing the prior authorization process was passed by the U.S. House of Representatives on Sept 14. Called the “Improving Seniors’ Timely Access to Care Act” (H.R. 3173), the bill would speed up the process for authorizing care for people in Medicare Advantage plans by requiring insurers to use electronic methods, not faxes or phone calls, to provide approvals. The bill would also require insurers to develop a system for providing real-time decisions in response to requests for items and services that are routinely approved. Currently, there is no standardization in the prior authorization process, which can lead to delay or denial of needed care.
The legislation was introduced in the House by Reps. Suzan DelBene (D-WA), Mike Kelly (R-PA), Ami Bera (D-CA), and Larry Bucshon (R-IN) and has the support of the American Medical Association and American Hospital Association. The Senate version of the bill was introduced by Roger Marshall (R-KS).
The Congressional Budget Office has put a ten-year price tag of $16.2 billion on the bill, raising cost concerns for some lawmakers.
