WHAT THEY ARE SAYING: H.R. 8487, Improving Seniors’ Timely Access to Care Act of 2022
WASHINGTON, DC—As the Ways and Means Committee begins marking up H.R. 8487, Improving Seniors’ Timely Access to Care Act of 2022, key stakeholders have shared their praise for the commonsense, bipartisan legislation led by Representatives Suzan DelBene (D-WA), Mike Kelly (R-PA), Ami Bera (D-CA), and Larry Bucshon (R-IN).
Nearly all Medicare Advantage (MA) plans require physicians and other health care providers to obtain prior authorization for certain services. A recent survey of physicians by the American Medical Association (AMA) found that 93 percent report that prior authorizations cause care delays and 83 percent said the process leads patients to abandon treatments all together. H.R. 8487 will remove barriers to care by improving the efficiency and transparency of prior authorization in MA.
Here’s what key stakeholders are saying:
“We are pleased that the Committee is marking up legislation that will better protect MA enrollees from inappropriate denials of prior authorization requests and take an important first step in implementing the OIG’s recommendations to approve oversight of prior authorization requests submitted to MA providers. It is critical that all Medicare beneficiaries whether enrolled in MA or traditional Medicare – are treated equitably and have timely access to all necessary health care services.”
“H.R. 8487 will improve the prior authorization process for both patients and physician practices by increasing transparency, streamlining processes, and minimizing the use of prior authorization for services that are routinely approved. This bipartisan legislation has been endorsed by more than 500 organizations representing patients, providers and the medical technology and biopharmaceutical industry.”
“This bill would reform the burdensome prior authorization process under Medicare Advantage (MA) by making the process electronic and transparent, to ensure patients receive timely access to critical health care services…The AAOS believes this legislation will help decrease the burden associated with prior authorizations and allow patients to receive the care they need without unnecessary delays.”
“We greatly appreciate that the Ways and Means Committee is considering the Improving Seniors’ Timely Access to Care Act of 2022, which would address many of these concerns by establishing requirements for the use of prior authorization under MA plans…These policies to streamline MA prior authorization requirements by eliminating complexity and promoting uniformity would reduce the wide variation in prior authorizations methods that frustrate both patients and providers.”
“The additional sections of the legislation mandating MA plans to issue faster prior authorization decisions are crucial policy improvements that will ensure more timely access to care and, as a result, improved patient health care outcomes and better stewardship of scarce Medicare resources…The AMA is proud to support the Improving Seniors’ Timely Access to Care Act. We commend the Ways and Means Committee for marking up this crucial bill and stand ready to work to ensure bipartisan passage by the House of Representatives.”
“With Medicare Advantage already delivering a 94% satisfaction rate, nearly $2,000 in annual consumer savings, and lower per-beneficiary government spending, the Improving Seniors’ Timely Access to Care Act offers a commonsense, bipartisan solution to further strengthen this valuable coverage option for our nation’s seniors. H.R. 8487 will build on the work the Medicare Advantage community has already undertaken to modernize prior authorization while protecting its essential function in facilitating high-value, clinically appropriate care.”
“On behalf of the nearly 50,000 physician members of the California Medical Association (CMA) and the thousands of patients we serve, we are writing in strong support of the bipartisan ‘Improving Seniors Timely Access to Care Act’ that will be marked up in Committee on July 27, 2022. This legislation provides comprehensive reform of the Medicare Advantage prior authorization process by streamlining the health plan bureaucracy to help Medicare patients get the care they need – when they need it.”
“Enacting this bill aimed at improving some elements of MA plans’ use of prior authorization and data collection would be an important first step towards imposing additional, needed oversight of Medicare Advantage (MA) plans. We strongly support recent improvements to the bill that include transparency and reporting requirements that will apply broadly to all prior authorization decisions, along with the requirement that such information be publicly available.”
“Recently, the Inspector General for the U.S. Department of Health and Human Services (HHS) found that 13 percent of denials made by Medicare Advantage (MA) plan for prior authorizations were improper. That’s reason enough for why this legislation is so desperately needed to help MA beneficiaries receive the same service and treatments available under traditional Medicare. We thank Chairman Neal for improving on prior versions of the bill to better protect beneficiaries, including strengthening the transparency provisions and providing enrollees’ access to prior authorization criteria.”
“This committee’s action is a critical step toward fulfilling our coalition’s goal of ensuring that physicians spend more time treating patients and less time overcoming bureaucratic hurdles and barriers to care. With more than 300 House co-sponsors and over 500 endorsing organizations representing patients, providers, and the medical technology and biopharmaceutical industry, it is time for this bill to become the law of the land. ”