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:
- 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.