A bipartisan bill aiming to reform prior authorization has been reintroduced in the Senate.
The Improving Seniors' Timely Access to Care Act seeks to streamline the prior auth process in Medicare Advantage (MA), which would ease administrative burdens on providers and reduce delays in accessing care for patients.
The bill is co-sponsored by Sens. Roger Marshall, R-Kan., and Mark Warner, D-Va., and is supported by dozens of senators on both sides of the aisle. A version of the legislation in the House is also backed by a bipartisan group.
“Prior authorization is the number one administrative burden facing physicians today across all specialties,” Marshall said in a press release. “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."
The bill is also supported by multiple industry groups and insurers, including Humana, one of the leading players in MA. Humana CEO Jim Rechtin reiterated the company's backing for the reforms in a statement Wednesday.
"Humana’s job is to ensure our members have access to high quality, affordable healthcare," Rechtin said. "We support efforts in the House and Senate to move the Seniors’ Timely Access to Care Act forward quickly. It is a common-sense approach to making healthcare easier by modernizing the prior authorization process."
The Better Medicare Alliance, an organization championing a strong MA program, also expressed support for the bill upon its reintroduction, with CEO Mary Beth Donahue saying that while prior authorization does play a necessary role in ensuring care provided to seniors is appropriate, "the process should be easier."
Other notable supporters of the bill include the American Medical Association and the American Hospital Association.
Despite the legislation's bipartisan and industry support, it fell short of passage last year. The Regulatory Relief Coalition (RRC), a group of physician organizations, said the Congressional Budget Office's (CBO's) score held the bill back from becoming law.
Policy changes implemented by the Centers for Medicare & Medicaid Services in January 2024 also decreased the CBO score by a significant margin, the RRC said.
“This commonsense legislation must be passed,” said Michael Repka, M.D., president of the American Academy of Ophthalmology, in the RRC's release. “Prior authorization creates unnecessary barriers to medically necessary care, ultimately harming patients."