The House of Representatives passed the Improving Seniors’ Access to Timely Care Act by a voice vote — Now it’s time for the Senate to act! This bipartisan legislation would require Medicare Advantage plans to adopt transparent prior authorization programs that adhere to evidence-based medical guidelines and hold plans accountable for making timely prior authorization determinations and providing rationales for denials.
After garnering more than 300 bipartisan cosponsors, H.R. 3173, the Improving Seniors’ Timely Access to Care Act of 2022 passed the House of Representatives via voice vote in September. The associated score from the Congressional Budget Office (CBO) for this legislation, however, was $16 billion. This high score was driven by what many medical associations perceive as an incorrect assumption that reductions in prior authorization subsequently permit physicians to perform more services, which, in turn, leads to higher spending for Medicare Advantage plans.
The release of this regulation is supposed to play a positive role in reducing the total CBO score. Congressional leaders are already in the process of trying to obtain a new CBO score in hopes that it is substantially lower and, as a result, more politically viable. The timing of a new CBO score, however, is unclear. In the meantime, we will continue to urge Congress, especially the Senate, to pass the bipartisan Improving Seniors’ Timely Access to Care Act before the end of 2022. Learn more and contact your senator today.