The Improving Seniors’ Timely Access to Care Act (H.R.8702/S.4518) was officially reintroduced in both the U.S. House of Representatives and Senate on Wednesday, June 12, 2024.  This critically important bipartisan legislation is supported by both the House and Senate, builds off the recently implemented prior authorization (“PA”) final rules to further streamline the prior authorization process under Medicare Advantage (“MA”), allowing seniors to get the care they need and helping health care providers put patients over paperwork.

Specifically, the bill would accomplish the following:

• Establish an electronic prior authorization (“e-PA”) process for MA plans including a standardization for transactions and clinical attachments.
• Increase transparency around MA prior authorization requirements and its use.
• Clarify CMS’ authority to establish timeframes for e-PA requests including expedited determinations, real-time decisions for routinely approved items and services, and other PA requests.
• Expand beneficiary protections to improve enrollee experiences and outcomes.
• Require HHS and other agencies to report to Congress on program integrity efforts and other ways to further improve the e-PA process.

 

The bill currently has 136 House cosponsors and 6 sponsors in the Senate.  NARA was one of over 370 national and state organizations representing patients, MA plans, hospitals, and other key stakeholders in the health care industry that has endorsed this bill.  Now is the time to take action and ask your Congressional members to support these bills and work together to get it across the finish line and enacted into law during the 118th Congress.