On Sept. 14, the U.S. House of Representatives unanimously passed by voice vote H.R. 3173, the Improving Seniors’ Timely Access to Care Act. Sponsored by Reps. Suzan DelBene (D-Wash.), Mike Kelly (R-Pa.), Ami Bera, MD, (D-Calif.) and Larry Bucshon, MD, (R-Ind.), the legislation would streamline and standardize prior authorization in the Medicare Advantage (MA) program. Among other things, the legislation:
- Establishes an electronic prior authorization process;
- Requires the U.S. Department of Health & Human Services to establish a process for real-time decisions for items and services that are routinely approved;
- Improves transparency by requiring MA plans to report to the Centers for Medicare & Medicaid Services on the extent of their use of prior authorization and the rate of approvals or denials; and
- Encourages plans to adopt prior authorization programs that adhere to evidence-based medical guidelines in consultation with physicians.
The American Association of Neurological Surgeons (AANS)/Congress of Neurological Surgeons (CNS) Washington Committee issued a press release applauding the passage of this legislation. Attention now turns to the U.S. Senate for its consideration. Sens. Roger Marshall, MD, (R-Kan.), Kyrsten Sinema (D-Ariz.), John Thune (R-S.Dak.) and Sherrod Brown (D-Ohio) have introduced a companion bill, S. 3018, with the same title.
