Rep. Bera, Colleagues Reintroduce Bipartisan Improving Seniors’ Timely Access to Care Act

Today, U.S. Representative Ami Bera, M.D. (D-CA-06) reintroduced the Improving Seniors’ Timely Access to Care Act alongside Representatives Mike Kelly (R-PA-16), Suzan DelBene (D-WA-01), John Joyce, M.D. (R-PA-13), and Senators Roger Marshall, M.D. (R-KS) and Mark Warner (D-VA). This bipartisan, bicameral legislation streamlines the outdated prior authorization process in Medicare Advantage (MA). 

With nearly 33 million Americans enrolled in Medicare Advantage, the bill updates a system that has become a top administrative burden for providers and a barrier to timely care. Audits by the Department of Health and Human Services Inspector General have found that Medicare Advantage plans subjected enrollees to unnecessary delays, incorrectly denied medically necessary care, and ultimately approved 75% of requests that were initially denied.

“As a doctor, I’ve seen firsthand how the broken prior authorization process delays needed care and frustrates both seniors and their physicians,” said Representative Ami Bera, M.D. (CA-06). “The Improving Seniors’ Timely Access to Care Act cuts through red tape and makes it easier for seniors on Medicare Advantage to access the treatments and services they need, when they need them. This bipartisan legislation is a common-sense fix that puts patients over paperwork, restores trust in the system and helps physicians focus on delivering quality care. I’m proud to reintroduce this bill alongside my colleagues and am grateful for the broad coalition of support behind it.”

The bill would:

• Require MA plans to adopt an electronic prior authorization (e-PA) system with standardized transactions
   
• Improve transparency around MA Prior Authorization use and requirements
   
• Clarify HHS’ authority to set timelines for determinations, including real-time decisions for routine items
   
• Mandate HHS and other agencies report on oversight and further improvements to the e-PA process

The bill continues to draw widespread backing. In the 117th and 118th Congresses, it was endorsed by more than 500 organizations representing patients, providers, medical technology innovators, biopharmaceutical companies, and health plans. 

The bill text can be found here.