The U.S. House of Representatives on Sept. 14 unanimously approved bipartisan legislation introduced by U.S. Rep. Larry Bucshon (R-IN) that would modernize the Medicare Advantage prior authorization process. The bill now heads to the U.S. Senate, where it also has strong bipartisan support.
Rep. Bucshon is one of 91 original cosponsors of the Improving Seniors’ Timely Access to Care Act of 2021, H.R. 3173, which U.S. Rep. Suzan DelBene (D-WA) sponsored on May 13, 2021, to help make it easier for the nation’s 28 million seniors enrolled in Medicare Advantage to obtain needed care in a timely manner, according to a fact sheet released by the lawmakers.
“Seniors and their families should be focused on getting the care they need, not faxing forms multiple times for procedures that are routinely approved,” Reps. Bucshon, DelBene, and two of their colleagues said in a joint statement released on Wednesday.
The delay, they said, “takes away valuable time from providers who on average spend 13 hours a week on administrative paperwork related to prior authorization.”
If enacted, Rep. Bucshon and the members said the bill also would cut unnecessary red tape in the healthcare system. “We urge the Senate to quickly take up this legislation and get it to President Biden’s desk,” they said.
H.R. 3173, which currently has a total of 326 cosponsors in the House, is the companion bill to the same-named S. 3018, which U.S. Sens. Roger Marshall (R-KS) and Kyrsten Sinema (D-AZ) introduced in October 2021. The Senate version of the bill currently has 42 other cosponsors.
Among several provisions, the bill would establish an electronic prior authorization process and require the U.S. Department of Health and Human Services to establish a process for real-time decisions about items and services that are routinely approved, according to the fact sheet.
Additionally, the measure would improve transparency by requiring Medicare Advantage plans to report to the Centers for Medicare and Medicaid Services on the extent of their use of prior authorization and the rate of approvals or denials; and encourage plans to adopt prior authorization programs that adhere to evidence-based medical guidelines in consultation with physicians, the fact sheet says.