Vol. 66, Issue 30
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IN THIS ISSUE
- House Overwhelmingly Passes Bill to Extend Medicare Telehealth Flexibilities for Additional Two Years
- WHA-Supported Bill to Improve Medicare Advantage Prior Authorization Clears House Committee
- Manchin and Schumer Announce Reconciliation Deal to Extend ACA Subsidies
- HRSA Announces Availability of Nearly $15 Million to Expand and Support the Nursing Workforce
- Congress Sends Letters to Biden Administration Urging Support of Key Hospital Priorities
- Last Chance to Register for August 5 Post-acute Care Conference
- WHA Education Department Welcomes Catherine Hazeltine
- Seeking Nominations for the 2022 Global Vision Community Partnership Award
EDUCATION EVENTS
Mar. 14, 2025
2025 Physician Leadership Development ConferenceApr. 9, 2025
2025 Advocacy DayApr. 22, 2025
Nursing ServicesClick here to view quality event calendar
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Thursday, July 28, 2022
WHA-Supported Bill to Improve Medicare Advantage Prior Authorization Clears House Committee
On July 27, the House Ways and Means Committee voted to advance the Improving Seniors' Timely Access to Care Act.
This legislation, which is supported by WHA and the American Hospital Association, would establish various standardization and transparency requirements for the prior authorization practices of health insurers offering Medicare Advantage Plans. Among other things, it would require these plans to:
The committee's action to advance this legislation comes in the wake of more attention being focused on health insurer practices that unfairly interfere with patient care. WHA sent a comment letter to CMS in March highlighting many of the concerns from these practices and a May 2022 report from the Office of Inspector General found even more evidence showing insurers have been unfairly denying care.
Clearing the House Ways and Means Committee makes it more likely that the bill could come to the full House floor for a vote in the coming weeks or be added to an omnibus package that Congress takes up this summer or fall. The legislation now enjoys the support of 37 Senate and 306 U.S. House cosponsors including Reps. Moore, Grothman, Pocan, Kind and Gallagher from Wisconsin.
Contact WHA Vice President of Federal and State Relations Jon Hoelter with questions.
This legislation, which is supported by WHA and the American Hospital Association, would establish various standardization and transparency requirements for the prior authorization practices of health insurers offering Medicare Advantage Plans. Among other things, it would require these plans to:
- Establish an electronic prior authorization program to provide real-time decisions in response to requests for items and services that are routinely approved;
- Annually publish transparency information such as the percentage of requests approved and the average response time; and
- Create quality and timeliness standards for prior authorization determinations.
The committee's action to advance this legislation comes in the wake of more attention being focused on health insurer practices that unfairly interfere with patient care. WHA sent a comment letter to CMS in March highlighting many of the concerns from these practices and a May 2022 report from the Office of Inspector General found even more evidence showing insurers have been unfairly denying care.
Clearing the House Ways and Means Committee makes it more likely that the bill could come to the full House floor for a vote in the coming weeks or be added to an omnibus package that Congress takes up this summer or fall. The legislation now enjoys the support of 37 Senate and 306 U.S. House cosponsors including Reps. Moore, Grothman, Pocan, Kind and Gallagher from Wisconsin.
Contact WHA Vice President of Federal and State Relations Jon Hoelter with questions.