House passes AHA-supported bill to streamline MA prior authorization

The House today passed by voice vote the Improving Seniors’ Timely Access to Care Act (H.R. 3173), AHA-supported legislation that would streamline prior authorization requirements under Medicare Advantage plans. The bill would establish an electronic prior authorization process and reduce how long a health plan can consider a prior authorization request; create a “real-time decisions” process for routinely approved services; require plans to report on their prior authorization use and rate of approvals and denials; and encourage plans to adopt policies that adhere to evidence-based guidelines.

“Hospitals and health systems commend the U.S. House of Representatives for their passage of the Improving Seniors’ Timely Access to Care Act,” said AHA Executive Vice President Stacey Hughes. “In particular, we thank Reps. DelBene, Kelly, Bera and Buschon and the leadership of the Ways and Means and Energy and Commerce Committees for their work on this important issue. 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 health care workforce. The AHA is encouraged by Senate support on companion legislation and urges them to take action on these critical protections.”