Congress Re-Introduces Bill to Streamline Medicare Advantage Prior Authorizations

On June 12, House and Senate leaders reintroduced the bipartisan Improving Seniors’ Timely Access to Care Act which is aimed at streamlining prior authorization requirements for Medicare Advantage plans. This bill aims to expedite access to necessary treatments by proposing an electronic system for prior authorizations, reducing approval times, mandating reporting on prior authorization usage and outcomes, and promoting evidence-based policies.  Previously, the bill passed the House but faced additional challenges due to it’s $16 billion CBO score. However, CMS recently reduced this cost to zero by requiring public reports on real-time decisions and clarifying CMS’s authority over expedited determinations and timelines.  Read the bill here.