APTA-supported bipartisan legislation that takes on misuse of prior authorization in Medicare Advantage plans has made it through the U.S. House of Representatives. Now it's on to the Senate.
Known as the "Improving Seniors' Timely Access to Care Act" (H.R. 3173), the bill doesn't completely eliminate the use of prior authorization but would move Medicare Advantage toward a more transparent and less burdensome process — a longtime policy goal for APTA.
Specifically, the bill would establish an electronic prior authorization process, require the implementation of a "real-time" decision system for items and services that are routinely approved, mandate that MA plans provide more detailed reports on use of prior authorization to the U.S. Centers for Medicare & Medicaid Services (including their rates of approvals, denials, and average time for approvals), and press MA providers to do a better job of incorporating input from health care providers in their authorization programs and decisions.
APTA government affairs staff will monitor the progress of the bill in the Senate and provide updates and opportunities to make your voice heard as they arise. If you want to get an even closer look at APTA's advocacy efforts on Capitol Hill and connect with other members interested in working for change, join the APTA Advocacy Network.