American Speech-Language-Hearing Association

Urge Congress to Address Burdensome Prior Authorization in Medicare Advantage
Health insurers, including many Medicare Advantage plans, sometimes require providers to obtain prior authorization for certain health care services before they can provide care to their patients. Prior authorization is intended to ensure clinically appropriate treatments, but inappropriate use of prior authorization as a utilization management tool creates undue administrative burdens for providers and erects barriers for patients to access necessary care.

The Improving Seniors’ Timely Access to Care Act (H.R. 8702/S. 4532) would reduce administrative burden and maximize the time audiologists and speech-language pathologists spend caring for their patients. The bill focuses on enhancing transparency and oversight, improving communication, and streamlining administrative processes for prior authorization that would help ensure Medicare Advantage beneficiaries have timely access to audiology and speech-language pathology services.

In 2024, the Senate Permanent Subcommittee on Investigations released a report based on 280,000 pages of documents obtained from the largest MA plans, finding that these companies systematically and intentionally used prior authorization to boost profits by creating barriers to medically necessary services in post-acute care facilities. The report found that in particular UnitedHealthcare’s denial rates for skilled nursing facilities grew nine-fold between 2019 and 2022 alone.

Please complete the form to email your Senators and ask them to support H.R. 8702/S. 4532.

Download the Issue Brief [PDF] to learn more.

Thank you for being an ASHA Advocate!

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