News

The SIR-supported Improving Seniors’ Timely Access to Care Act (S. 1816/H.R. 3514) was reintroduced in Congress last week. The bipartisan, bicameral legislation aims to simplify the prior authorization (PA) process within the Medicare Advantage (MA) program. It would establish an electronic PA process for MA plans, increase transparency around MA prior authorization requirements, provide a pathway for the Centers for Medicare and Medicaid Services (CMS) to institute real-time decisions for routinely approved items and services and clarify CMS’ authority to establish timeframes for e-PA requests, expand beneficiary protections to improve enrollee experiences and outcomes, and require the U.S. Department of Health and Human Services to report to Congress on program integrity efforts and ways to further improve the e-PA process.

The bill is sponsored by Sens. Roger Marshall, MD, R-Kan.; and Mark Warner, D-Va.; and by Reps. Mike Kelly, R-Pa.; Suzan DelBene, D-Wash.; Ami Bera, MD, D-Calif., and John Joyce, MD, R-Pa. It currently has 47 cosponsors in the Senate, 77 cosponsors in the House of Representatives, and is supported by more than 150 stakeholder organizations including SIR. 

You can advocate for the passage of this bill and other important legislation by going to the SIR Advocacy Action Center.