U.S. Senator Kirsten Gillibrand, along with a bipartisan group of senators, has reintroduced the Improving Seniors’ Timely Access to Care Act. This zero-cost legislation aims to enhance access to care for seniors enrolled in Medicare Advantage (MA) plans by streamlining the prior authorization process.
The bill targets reducing administrative burdens that currently detract from patient care, potentially benefiting the 32.8 million Americans and over two million New Yorkers enrolled in MA plans.
“Senior citizens have spent their entire lives contributing to our communities, and they deserve every resource to support their health and well-being,” said Senator Gillibrand. “The Improving Seniors’ Timely Access to Care Act will help cut through unnecessary red tape and ensure timely medical care is accessible to older Americans.”
Prior authorization requires healthcare providers to get pre-approval for services, which can lead to delays due to its cumbersome nature. Nearly three out of four Medicare Advantage enrollees experience such delays.
The proposed act would establish an electronic prior authorization process for MA plans, standardize transactions and clinical attachments, increase transparency around requirements, clarify HHS authority on timeframes for requests, expand beneficiary protections, require reporting on program integrity efforts, and codify elements of existing rules by CMS.
In addition to Senator Gillibrand’s sponsorship, the bill is supported by Senators Mark Warner (D-VA), Roger Marshall (R-KS), Maggie Hassan (D-NH), among others. Companion legislation has also been introduced in the House by Representatives John Joyce (R-PA-13), Mike Kelly (R-PA-16), Suzan DelBene (D-WA-01), and Ami Bera (D-CA-06).
The initiative has garnered endorsements from 140 healthcare organizations.
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