Today, Congressman Tim Ryan (OH-13) voted for the Improving Seniors' Timely Access to Care Act, legislation that would make it easier for over 2.4 million Ohio seniors eligible for Medicare Advantage to get the care they need and improve health outcomes. The bill would modernize the outdated Medicare Advantage prior authorization process, which often still requires faxing documents to insurance companies.
"No Ohioan should have to wait for lifesaving treatment because of an outdated system. When seniors go to the doctor, the focus should be on their health, not bureaucratic paperwork," said Congressman Ryan. "That's why I voted today for the Improving Seniors' Timely Access to Care Act so our seniors in Ohio can get the care they need when they need it."
Many Medicare Advantage plans require providers to obtain prior authorization for certain medical procedures and tests before they can provide care to their patients. Prior authorization can play a role in ensuring people receive appropriate treatments and help control the cost of care. However, when misused, prior authorization can delay medically necessary care and result in administrative burdens for providers.
The bill would:
Establish an electronic prior authorization process.
Require the U.S. Department of Health & Human Services (HHS) to establish a process for "real-time decisions" for items and services that are routinely approved.
Improve transparency by requiring Medicare Advantage plans to report to the Centers for Medicare & Medicaid Services (CMS) on the extent of their use of prior authorization and the rate of approvals or denials.
Encourage plans to adopt prior authorization programs that adhere to evidence-based medical guidelines in consultation with physicians.
The legislation has over 300 cosponsors in the House, including Congressman Ryan, and the endorsement of over 500 organizations