The Improving Seniors' Timely Access to Care Act Reintroduced In Congress

On June 12, 2024, Senator Roger Marshall reintroduced his bipartisan, bicameral Improving Seniors’ Timely Access to Care Act. The legislation is also sponsored by U.S. Senators Kyrsten Sinema (I-AZ), John Thune (R-SD), and Sherrod Brown (D-OH), and U.S. Representatives Mike Kelly (R-PA), Suzan DelBene (D-WA), Larry Bucshon, M.D. (R-IN) and Ami Bera, M.D. (D-CA). An additional 37 senators and 123 representatives also cosponsor the legislation, which has support from more than 370 national and state organizations that represent patients, physicians, Medicare Advantage (MA) plans, hospitals, and other stakeholders in the health care industry.

Under the legislation, an electronic prior authorization process would be established for MA plans, including a standardization for transactions and clinic attachments. It would also increase transparency around MA prior authorization requirements and clarify the authority that CMS has to establish timeframes for electronic prior authorization requests (including expedited determinations, real-time decisions for routinely approved items and services, and other prior authorization requests). The legislation would also require the Department of Health and Human Services (HHS) and other government agencies to report to Congress on program integrity efforts and other ways to further improve the electronic prior authorization process.

Additional information can be found here:

PriorAuth.pdf (senate.gov)