Senate Bill Speeds Prior Authorization for Medicare Advantage Plans

HomeCare November 23, 2021
Kristin Easterling

WASHINGTON, D.C. (November 23, 2021)—Bipartisan legislation introduced in the United States Senate would ease, standardize and speed the process of prior authorization in Medicare Advantage plans.

The Improving Seniors’ Timely Access to Care Act would automate the prior authorization process in Medicare Advantage (MA) plans through electronic submission of prior authorization requests with real-time determinations by the MA plans. The legislation encourages integration of the electronic prior authorization submission into electronic medical record systems.

The Secretary of Health and Human Services would be tasked with developing standards in conjunction with stakeholder input. In addition, certain transparency requirements would be put in place. These include:

• A list of services and items subject to prior-authorization;
• The percentage of prior authorization requests...

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