AHA expresses support for bill establishing requirements for use of prior authorization under MA plan

The AHA today expressed support for the Improving Seniors’ Timely Access to Care Act of 2021 (H.R. 3173), bipartisan legislation that would establish requirements for the use of prior authorization under Medicare Advantage plans.

“America’s hospitals and health systems are committed to ensuring patient access to the highest quality care in a timely manner,” AHA said today in a letter to the bill’s sponsors, Reps. Suzan DelBene, D-Wash.; Mike Kelly, R-Pa.; Ami Bera, D-Calif.; and Larry Bucshon, R-Ind. “Your bill seeks to streamline and improve prior authorization processes, which would help providers spend more time on patients, instead of paperwork. We commend you for your focus on this important issue and look forward to working with you to make improvements to the prior authorization process to ensure patient access.”

Prior authorization is a tool that can help align patients’ care with their health plan benefit structure and facilitate alignment with clinical best practices when used appropriately. However, these processes vary widely among health plans and insurers, and the lack of standardization can be confusing and burdensome for providers. Certain health plan utilization management practices can, when poorly structured or implemented, create unnecessary delays in care that can negatively affect patients.