(June 12, 2024) - Today, a group of Senators and Representatives led by Senator Roger Marshall (R-KS) introduced the 2024 version of the Seniors’ Timely Access to Care Act. The bill continues streamlining the prior authorization process for beneficiaries of Medicare Advantage plans. It also strengthens and codifies recent rule changes made by the Centers for Medicare & Medicaid Services to address unnecessary administrative burdens for clinicians and hospitals posed by MA plans. The Kansas Hospital Association appreciates Senator Marshall's steadfast leadership on this bill and thanks Senator Jerry Moran (R-KS), and Representatives Tracey Mann (R-KS), Jake LaTurner (R-KS), Sharice Davids (D-KS), and Ron Estes (R-KS) for being original cosponsors.
Specifically, the Seniors’ Timely Access to Care Act would:
- Establish an electronic prior authorization process for MA plans, including standardization for transactions and clinical attachments.
- Increase transparency around MA prior authorization requirements and its use.
- Clarifies CMS’ authority to establish time frames for e-PA requests including expedited determinations, real-time decisions for routinely approved items and services, and any other PA request.
- Expands beneficiary protections to improve enrollee experiences and outcomes.
- Requires the U.S. Department of Health and Human Services and other agencies to report to Congress on program integrity efforts and other ways to further improve the e-PA process.
The previous version of this bill passed the House in the 117th Congress but could not pass the Senate due to concerns regarding the cost. However, due to CMS' previous actions and certain public reporting requirements in this Congress' version, the bill is expected to be budget neutral and has a good chance of becoming law.