ACC Priority Legislation Addressing Prior Authorization Passes House

The Improving Seniors' Timely Access to Care Act of 2021 (H.R. 3173), an ACC Advocacy priority that would improve and modernize prior authorization within Medicare Advantage, passed the U.S. House of Representatives on Sept. 14.

The ACC, with more than 500 other organizations and stakeholders, has been a key advocate for this bill since its introduction in 2019. Specifically, it would improve prior authorization by:

  • Establishing an electronic prior authorization program;
  • Standardizing and streamlining the prior authorization process for routinely approved services, including establishing a list of services eligible for real-time prior authorization decisions;
  • Ensuring prior authorization requests are reviewed by qualified medical personnel; and
  • Increasing transparency around Medicare Advantage prior authorization requirements and their use.

"The Improving Seniors' Timely Access to Care Act would increase efficiency and transparency for prior authorization within the Medicare Advantage program," said ACC President Edward T. A. Fry, MD, FACC. "This legislation will help the patients we treat, while also reducing administrative burden, removing barriers to care, lowering the cost of care, and improving care team well-being."

The legislation now awaits action in the Senate, where it currently has 42 bipartisan cosponsors. Advancing this bill in the Senate will be a focus of ACC's Legislative Conference 2022 taking place from Oct. 16-18.

Keywords: ACC Advocacy, Medicare Part C, Prior Authorization, Quality Improvement, Health Services Accessibility, Electronics


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