Congress Introduces Bipartisan Bill to Streamline Prior Authorization in Medicare Advantage Plans

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On June 5, 2019, a bipartisan group of representatives introduced H.R. 3107, the Improving Seniors’ Timely Access to Care Act of 2019, in the House. This legislation would streamline the prior authorization process in Medicare Advantage plans to relieve administrative burdens that physicians face and reduce care delays.

The legislation addresses several issues highlighted in a recent survey published by the Regulatory Relief Coalition. According to this survey, 87 percent of physicians say that prior authorization requirements have either a somewhat or significant negative impact on their patients’ clinical outcomes, and 82 percent report that the prior authorization process often or always delays access to necessary care. According to the survey, 32 percent of physicians reported that their patients abandoned treatment because of prior authorization requirements.

This legislation would establish a process whereby routinely approved services could be approved in real-time. It would also require plans to establish an electronic prior authorization process. Additionally, this legislation would require health plans to report to the Secretary of the Department of Health and Human Services about how much they use prior authorization and how frequently they use it to approve or deny medical services. Aimed Alliance supports this congressional effort to streamline the prior authorization process in Medicare Advantage plans because it will help seniors get the right care at the right time, without unreasonable delays.

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