Cardiologist-supported prior authorization reform reintroduced in Congress
Legislation that would reform the prior authorization process for seniors covered by Medicare Advantage has been reintroduced in both the U.S. House of Representatives and U.S. Senate.
The Improving Seniors’ Timely Access to Care Act, if signed into law, would establish an electronic prior authorization process, help cardiologists and other clinicians gain real-time approval of routinely approved medical services and work to make prior authorization requirements more transparent, among other things.
Lawmakers from both parties have been attempting to get this legislation passed for years now. In the Senate, the bill was reintroduced by U.S. Sens. Roger Marshall, MD, of Kansas, Kyrsten Sinema of Arizona, John Thune of South Dakota and Sherrod Brown of Ohio. In the House, meanwhile, it was reintroduced by Reps. Mike Kelly of Pennsylvania, Suzan DelBene of Washington, Larry Bucshon of Indiana and Ami Bera, MD, of California.
“Prior authorization is the number one administrative burden facing physicians today across all specialties,” Marshall said in a prepared statement. “As a physician, I understand the frustration this arbitrary process is causing healthcare practices across the country and the headaches it creates for our nurses. With the bipartisan, bicameral, Improving Seniors’ Timely Access to Care Act, we will streamline prior authorization and help improve patient outcomes and access to quality care and life-saving medicine. With the improvements we’ve made there is no reason we should not quickly get this bill signed into law.”
“Modernizing and streamlining the prior authorization process is critical for South Dakota seniors and providers,” Thune added. “This bipartisan legislation would remove unnecessary red tape, make healthcare more efficient, and ensure patients can access care when they need it.”
The bill was unanimously passed by the House in 2023. Could 2024 be the year it makes it all the way to the president's desk?
Cardiology groups show support for Improving Seniors’ Timely Access to Care Act
The American College of Cardiology (ACC), Society for Cardiovascular Angiography and Interventions (SCAI) and other medical society groups have been consistent supporters of prior authorization reform over the years, perhaps because these policies impact cardiology on such a regular basis. In fact, the ACC has already issued a new statement urging Congress to pass the newly reintroduced legislation.
"The ACC has long supported the Improving Seniors’ Timely Access to Care Act as a means to streamline and modernize the prior authorization process in Medicare Advantage by mandating E-prior authorization and implementing transparency rules,” ACC President Cathie Biga, MSN, RN, said in the statement. “Prior authorization is regularly identified as a key source of burnout for healthcare workers as it is often an unnecessary, time-consuming process that ultimately causes avoidable delays in patient care. All patients, especially those who are older and most at risk, deserve timely access to the care they need. We must trust our clinicians to deliver the right care at the right time for the right patient. The ACC urges the passage of this legislation and will continue working with Congress to underscore the importance of additional prior authorization reforms, including real-time decision-making."
SCAI, meanwhile, has been vocal about its support of the bill in the past. In 2021, the group highlighted the potential impact prior authorization reform could have on patient care.
“Prior authorization is costly and time consuming,” Timothy D. Henry, MD, the group’s president at the time, said at the time. “The Improving Seniors’ Timely Access to Care Act of 2021 works to reform this process and improve patient outcomes. This type of ‘red tape’ is bad for patients, bad for physicians and bad for taxpayers.”
Michael has more than 16 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.