Background:

The negative effects of prior authorization policies and practices among MA plans are well-documented. With at least 155 cosponsors in the House of Representatives and 44 cosponsors in the Senate, the Improving Seniors’ Timely Access to Care Act is a bipartisan solution to many of the problems patients and their physicians experience in MA plans. This legislation would improve the prior authorization process and provide greater transparency within the MA program by:

• Mandating that all MA plans adopt electronic prior authorization capabilities to streamline the process for prior authorization approval.
• Protecting beneficiaries from any disruptions in care due to prior authorization requirements as they transition between MA plans.
• Standardizing the process and procedures for reporting electronic prior authorization criteria to MA plans and mandating that all MA plans issue prompter prior authorization decisions.
• Ensuring prior authorization requests are reviewed by qualified medical personnel.
• Increasing transparency around prior authorization requirements.

The Improving Seniors’ Timely Access to Care Act passed the House in the last Congress but failed to advance in the Senate (even though a majority of Senate members supported the bill) due to the Congressional Budget Office’s (CBO) cost estimate for implementing the bill. Fortunately, estimates on the cost of this bill have been reduced significantly and the bill was reintroduced last month. We now need your help to get it across the finish line.

Action Requested: Please urge your members of Congress to support and pass (H.R.8702/S.4532) which would streamline the prior authorization process for Medicare Advantage plans. A sample message has been provided for you that can be personalized. 

Thank you for your continued advocacy.

Please contact Shuan Tomlinson at stomlinson@acponline.org with any questions about this campaign.