Policy & Medicine June 12, 2022
Thomas Sullivan

In mid-May 2022, H.R. 3173, the Improving Seniors’ Timely Access to Care Act of 2021 surpassed the 290-cosponsor threshold needed to include the legislation on the House Consensus Calendar. If passed, the bipartisan bill would streamline and standardize prior authorization in the Medicare Advantage (MA) program.

Under the legislation, MA plans would need to: (1) establish an electronic prior authorization program that meets specified standards, including the ability to provide real-time decisions in response to requests for items and services that are routinely approved; (2) annually publish specified prior authorization information, including the percentage of requests approved and the average response time; and (3) meet other standards, as set by the Centers for Medicare & Medicaid Services (CMS), relating to...

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