American College of Radiology® (ACR®)-supported prior authorization legislation advanced in the U.S. House Committee on Ways and Means July 27. The Improving Seniors’ Timely Access to Care Act (HR 8487/HR 3173), introduced by Representatives Suzan DelBene (WA-01), Mike Kelly (PA-16), Ami Bera, MD (CA-07), and Larry Bucshon, MD (IN-08), has achieved more than 300 bipartisan cosponsors in the House.
HR 8487/HR 3173 would establish several requirements and standards relating to prior authorization processes under Medicare Advantage (MA) plans in order to reduce administrative burden and improve patient care. Specifically, the legislation would:
- Shorten the timeframe for MA plans to make prior authorization decisions.
- Streamline administrative processes by moving insurers and providers to fully electronic transactions.
- Inject more transparency into the prior authorization process by requiring the collection and publication of additional information, such as the number of prior authorization requests, the rates of approvals and denials, and the rates of successful appeals.
Although the bill has passed out of the Committee on Ways and Means, it is uncertain whether the House Committee on Energy and Commerce will assert jurisdiction over the legislation or whether the bill will head next to the House floor for a vote.
The ACR will continue to monitor this legislation as it advances. For more information, please contact Rebecca Spangler, ACR Senior Government Affairs Director.