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After falling short last Congress, prior auth bill primed for passage

| 2 Min Read

CHICAGO – With the American Medical Association’s (AMA) strong support, members of the House and Senate introduced bipartisan legislation today to streamline and standardize the use of prior authorization within Medicare Advantage, building on its widespread support in the last Congress.

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An updated version of the Improving Seniors’ Timely Access to Care Act features targeted policy changes to reduce the scored cost of the legislation, which was an obstacle last Congress. 

“We thank the sponsors for writing the bill so it will attract even more support. We came close last Congress to passing this much-needed reform. Our patients know all too well that prior authorization needs a dramatic overhaul. We think this is the year to get this bill over the finish line,” said AMA President Bruce A. Scott, M.D.

In the 117th Congress, the bill garnered 378 total bipartisan cosponsors in the House and Senate and also passed the full House of Representatives. In addition, the legislation secured endorsements from more than 500 outside organizations, including the AMA and numerous national and state medical associations. Again, this year, the bill has similar widespread support.

Members of Congress have been spurred by stories from Medicare Advantage patients who have faced unnecessary delays in treatment and diagnoses because of the administrative hurdles erected by prior authorization.

“This legislation will streamline the prior authorization process so physicians can offer patients safe, timely and affordable care. Those decisions should be made between patients and their doctors without being second-guessed by insurers. The bipartisan and bicameral support for the bill is evidence that this is a common-sense proposal that deserves to be passed,” Dr. Scott said.

The AMA commends the sponsors of the bill: Sens. Roger Marshall, M.D. (R-KS), Krysten Sinema (I-AZ), John Thune (R-SD), and Sherrod Brown (D-OH), as well as Reps. Mike Kelly (R-PA), Suzan DelBene (D-WA), Ami Bera, M.D. (D-CA), and Larry Bucshon, M.D. (R-IN). The text of the legislation can be found here (PDF).

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About the American Medical Association

The American Medical Association is the physicians’ powerful ally in patient care. As the only medical association that convenes 190+ state and specialty medical societies and other critical stakeholders, the AMA represents physicians with a unified voice to all key players in health care.  The AMA leverages its strength by removing the obstacles that interfere with patient care, leading the charge to prevent chronic disease and confront public health crises and, driving the future of medicine to tackle the biggest challenges in health care.

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