WASHINGTON—U.S. Senators John Boozman (R-AR), Roger Marshall, M.D. (R-KS) and Mark Warner (D-VA) introduced the bipartisan Improving Seniors’ Timely Access to Care Act, legislation to speed up access to care for Americans enrolled in Medicare Advantage (MA) plans by streamlining the prior authorization process and ultimately allowing healthcare providers to spend more time on patient care rather than administrative burdens.

This legislation would help physicians better serve the 32.8 million Americans – including the over 300,000 Arkansans – enrolled in a MA plan.

“Quality, expedited medical care should always be within reach for seniors, and our providers deserve a system that helps them focus on delivering it,” Boozman said. “I’m pleased to join this bipartisan effort to end the inefficient process that delays Medicare Advantage beneficiaries’ evaluations and treatments while removing an unnecessary, bureaucratic burden on clinicians.”

“Prior authorization is the number one administrative burden facing physicians today across all specialties,” said Marshall. “As a physician, I understand the frustration this arbitrary process is causing health care practices across the country and the headaches it creates for our nurses. With the bipartisan, bicameral Improving Seniors’ Timely Access to Care Act, we will streamline prior authorization and help improve patient outcomes and access to quality care.”

“Our seniors deserve high-quality care delivered in a timely fashion. I am proud to introduce this legislation that takes commonsense steps to modernize the prior authorization process, cutting through red tape, streamlining approvals, and making sure our health care providers are focused on what really matters — supporting their patients,” said Warner. 

The Improving Seniors’ Timely Access to Care Act would:

• Establish an electronic prior authorization process for Medicare Advantage plans, including a standardization for transactions and clinical attachments;
• Clarify the Department of Health and Human Services’ (HHS) authority to establish timeframes for e-prior authorization requests, including expedited determinations, real-time decisions for routinely approved items and services, and other prior authorization requests;
• Require HHS and other agencies to report to Congress on program integrity efforts and other ways to further improve the e-prior authorization process; and 
• Expand beneficiary protections to improve enrollee experiences and outcomes.

Forty-four senators have cosponsored the bill and companion legislation has been introduced in the U.S. House of Representatives.

The Improving Seniors’ Timely Access to Care Act is supported by the Better Medicare Alliance, Humana and 138 other health care organizations. Here’s what they are saying about the bill: 

“Prior authorization helps keep health care costs low and ensures seniors are getting the most appropriate care. But the process should be easier. The changes put forth in this legislation are long overdue and will help ensure seniors can get the care they need without delay,” said President and CEO of Better Medicare Alliance Mary Beth Donahue. 

“Humana’s job is to ensure our members have access to high quality, affordable healthcare.  We support efforts in the House and Senate to move the Seniors’ Timely Access to Care Act forward quickly,” said Humana CEO Jim Rechtin. “It is a common-sense approach to making healthcare easier by modernizing the prior authorization process.”

Text of the bill is available here.