Senators Marshall, MD (R-KS) and Sinema (D-AZ) have introduced their companion legislation - The Improving Seniors' Timely Access to Care Act (S.3018). Like the House bill, this bipartisan legislation would require Medicare Advantage plans to adopt transparent prior authorization programs that adhere to evidence-based medical guidelines and hold plans accountable for making timely prior authorization determinations and providing rationales for denials.

Specifically, the bill would:

• Create an electronic prior authorization program that adheres to federally developed standards and includes the electronic transmission of prior authorization requests and responses, as well as a real-time process for items and services that are routinely approved;
• Improve transparency by requiring plans to report to Centers for Medicare & Medicaid Services on the extent of their use of prior authorization and the rate of approvals or denials;
• Require plans to adopt transparent PA programs that are reviewed annually and allow for modification of prior authorization requirements based on providers' adherence to evidence-based medical guidelines; and
• Hold plans accountable for making timely prior authorization determinations and providing rationales for denials.

The demand and need for such reforms is growing — particularly as more seniors choose Medicare Advantage for their health insurance needs. For far too long, insurance companies have hidden behind prior authorization requirements in order to cut costs and boost their bottom line, all at the expense of the patient. The Improving Seniors’ Timely Access to Care Act of 2022 would change this dynamic by taking meaningful steps to curb insurers’ abuse of prior authorization requirements in order to save money, as well as protect patients from care disruptions.

There are only a handful of legislative days left this year for the Senate to get this legislation over the finish line, please join us in the fight today to get our health care system back on track by fixing the broken prior authorization system.

Please use this form to contact your Senators today and urge them to cosponsor the Improving Seniors' Timely Access to Care Act!