Senator Marshall Celebrates over 500 Endorsements of the Improving Seniors’ Timely Access to Care Act

Washington, D.C. - U.S. Senator Roger Marshall, M.D. released the following statement after the Improving Seniors' Timely Access to Care Act, bipartisan, bicameral legislation that would speed up access to quality care for seniors by streamlining prior authorization under Medicare Advantage, received over 500 health care and patient advocacy organizations endorsement:

"Our bipartisan, Improving Seniors' Timely Access to Care Act legislation cuts out burdensome prior authorization forms and pulls back the curtain on the process so physicians can focus on what they love most: delivering quality care to their patients," said Senator Marshall. "With over 500 patient and provider advocacy groups supporting our legislation, we know we are over the target with a solution that can and will improve patient outcomes. Physicians want to focus on patient care over paperwork; it's that simple."

To see the list of supporting organizations, click here.

The legislation is supported by the majority of Congress, with 60 cosponsors in the Senate and 230 cosponsors in the House of Representatives. The bill passed unanimously in the House of Representatives in the last Congress. You may read the full bill here.

Background on the Improving Seniors' Timely Access to Care Act:

Prior authorization is a tool used by health plans to reduce unnecessary care by requiring health care providers to get pre-approval for medical services. But it's not without fault. The current system often results in unconfirmed faxes of a patient's medical information or phone calls by clinicians which takes precious time away from delivering quality and timely care. Prior authorization continues to be the #1 administrative burden identified by health care providers, and three out of four Medicare Advantage enrollees are subject to unnecessary delays due to prior authorization. In recent years, the Office of the Inspector General at the U.S. Department of Health and Human Services (HHS) raised concerns after an audit revealed that Medicare Advantage plans ultimately approved 75% of requests that were originally denied. More recently, HHS OIG released a report finding that MA plans incorrectly denied beneficiaries' access to services even though they met Medicare coverage rules.

Health plans, health care providers, and patients agree that the prior authorization process must be improved to better serve patients and reduce unnecessary administrative burdens for clinicians. In fact, leading health care organizations released a consensus statement to address some of the most pressing concerns associated with prior authorization.

Specifically, the bill would:

• Establish an electronic prior authorization process for MA plans including a standardization for transactions and clinical attachments.
• Increase transparency around MA prior authorization requirements and its use.
• Clarify CMS' authority to establish timeframes for e-PA requests including expedited determinations, real-time decisions for routinely approved items and services, and other PA requests.
• Expand beneficiary protections to improve enrollee experiences and outcomes.
• Require HHS and other agencies to report to Congress on program integrity efforts and other ways to further improve the e-PA process.