Lawmakers Reintroduce Bipartisan Bill To Update ‘outdated’ Medicare Advantage Prior Authorizations

On Wednesday, a slew of bipartisan lawmakers reintroduced a bill that would overhaul the prior authorization process for seniors enrolled in Medicare Advantage (MA) plans and cutting through some of the red tape facing home health providers.

The Improving Seniors’ Timely Access to Care Act would amend part of the Social Security Act and establish requirements for MA prior authorizations, aiming to increase transparency and require an electronic prior authorization system.

“As a doctor, I’ve seen firsthand how the broken prior authorization process delays needed care and frustrates both seniors and their physicians,” Rep. Ami Bera (D-California), one of the lawmakers backing the bill, said in a statement. “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.”

The bill has been introduced several times previously, including in 2022 and 2024. Specifically, the bill would require the electronic prior authorization system, require more transparency around MA prior authorization use and requirements, clarify the  U.S. Department of Health and Human Services (HHS)’s authority to set timelines for determinations and mandate that HHS and other agencies report on oversight to the electronic system. 

The bill would relieve some of the burden of “unnecessarily complicated” prior authorization processes, according to Rep. Maggie Hassan (D-New Hampshire)

“This bipartisan legislation is a commonsense way to support seniors on Medicare Advantage in accessing care, and to help health care providers focus on their patients instead of paperwork,” Hassan said in a statement.

The Better Medicare Alliance, a research and advocacy organization with members including MA beneficiaries, caregivers and health plans, lauded the bill.

“Prior authorization helps keep health care costs low and ensures seniors are getting the most appropriate care,” Mary Beth Donahue, president and CEO of the Better Medicare Alliance, said in a statement. “But the process should be easier. The changes put forth in this legislation are long overdue and will help ensure seniors can get the care they need without delay.”

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