March 1, 2022

AAPM&R is participating in the Week of Action, March 7-11, to 1) spread awareness of the barriers to timely care associated with prior authorization and 2) encourage Congressional action (committee action/additional co-sponsors) on The Improving Seniors’ Timely Access to Care Act of 2021 (HR 3173/ S 3018). We encourage you to participate next week by posting tweets and participating in the grassroots campaign in AAPM&R’s member action center.

Introduced by Reps. Suzan DelBene (D-WA), Mike Kelly (R-PA), Ami Bera, MD, (D-CA) and Larry Buchson, (R-IN) in the House and Sens. Krysten Sinema (D-AZ), John Thune (R-SD) and Sherrod Brown (D-OH), this bipartisan legislation would help protect patients from unnecessary delays in care by streamlining and standardizing prior authorization under the Medicare Advantage program, providing much-needed oversight and transparency of health insurance for America’s seniors. The Improving Seniors’ Timely Access to Care Act of 2021 would:

• Establish an electronic prior authorization (ePA) program and require MA plans to adopt ePA capabilities;
• Require the Secretary of Health and Human Services to establish a list of items and services eligible for real-time decisions under an MA ePA program;
• Standardize and streamline the prior authorization process for routinely approved items and services;
• Ensure prior authorization requests are reviewed by qualified medical personnel;
• Increase transparency around MA prior authorization requirements and their use; and
• Protect beneficiaries from any disruptions in care due to prior authorization requirements as they transition between MA plans.
  

AAPM&R has been a strong advocate of this bill for the past several years, prioritizing the bill in our 2020 and 2021 Hill Days. AAPM&R helped the bill’s introduction to both the 116^th and the current Congresses and helped it gain majority support in the House with more than 250 co-sponsors. Let’s get this bill passed into law!