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  • Washington Highlights

    AAMC-Supported Prior Authorization Reform Bill Passes House


    Allyson Perleoni, Director, Government Relations
    For Media Inquiries

    The House of Representatives passed the Improving Seniors’ Timely Access to Care Act of 2021 (H.R. 3173) by suspension on Sept. 14. The AAMC-supported legislation would add requirements that would better regulate the use of prior authorization in Medicare Advantage plans [refer to Washington Highlights, July 29].

    The legislation would make it easier for beneficiaries in Medicare Advantage plans to receive care in an efficient manner by making three key changes. This bill would move Medicare Advantage plans away from paper and fax prior authorization reviews in favor of an electronic prior authorization program that would streamline processes and save time for both providers and patients. In addition, this program would need to adhere to specified standards while supplying real-time decisions on normally approved tests and services. The bill would also require Medicare Advantage plans to annually collect and publish information on their use of prior authorization and report that data to the Centers for Medicare & Medicaid Services (CMS). Finally, the bill would require Medicare Advantage programs to meet other baseline standards of efficiency and quality set by the CMS.

    The Energy and Commerce Committee also marked up and passed the legislation on Sept. 14.  To be enacted, the legislation must be passed by the Senate and signed by the president.