Legislation introduced by U.S. Reps. Larry Bucshon (R-IN) and Mike Kelly (R-PA) to improve the timely access to health care for seniors is closer to becoming law after the U.S. Centers for Medicare and Medicaid Services (CMS) released a proposed rule on Tuesday that would streamline processes related to prior authorization for medical items and services.
Reps. Bucshon and Kelly have been working to further advance their bill, the Improving Seniors’ Timely Access to Care Act of 2022, H.R. 8487, since the U.S. House passed the legislation in September. The bill, which was sponsored by U.S. Rep. Suzan DelBene (D-WA), is bipartisan legislation that would modernize the way Medicare Advantage plans and health care providers use prior authorization.
Prior authorization is used by health plans to lower spending from improper payments and unnecessary care by requiring physicians and other health care providers to get pre-approval for medical services. But prior authorization continues to be the biggest administrative burden identified by health care providers.
“I am thrilled that the Centers for Medicare and Medicaid Services is working to address this through their proposed rule, taking key measures from the Improving Seniors’ Timely Access to Care Act to help fix and streamline the process,” Rep. Bucshon said. “This is an important step toward putting patients over paperwork, allowing doctors to spend more time providing direct patient care and ensuring individuals receive the services they need in an appropriate timeframe.”
H.R. 8487 has widespread support in Congress and over 500 organizations that represent patients, physicians, hospitals, and others in the health care industry have endorsed the legislation, Rep. Bucshon’s office said.
“When seniors go to the doctor, the focus should be on their health, not bureaucratic paperwork,” Rep. Kelly said, adding that’s why CMS’ proposed rule was so important. “It mirrors many of the most important elements of our bill, the Improving Seniors’ Timely Access to Care Act, and emphasizes the importance of an electronic prior authorizations system,” Rep. Kelly said.
While the congressman said the proposed rule doesn’t address every problem in the prior authorization space, “there is still need for Congress to legislate to protect our seniors.”