Over 500 Advocacy Groups Endorse Seniors’ Health Care Legislation Authored by Sens. Marshall, Sinema, Thune, and Brown

(Washington, D.C., July 19, 2022) – In October 2021 U.S. Senators Roger Marshall, M.D. (KS), Kyrsten Sinema (AZ), John Thune (SD), and Sherrod Brown (OH) introduced the Improving Seniors’ Timely Access to Care Act, bipartisan legislation that would improve timely access to quality care for seniors under Medicare Advantage. Specifically, the bill would modernize the way Medicare Advantage plans and health care providers use prior authorization.

Since its introduction, over 500 organizations that represent patients, physicians, hospitals, and other key stakeholders in the health care industry have officially endorsed the legislation. Upon their legislation reaching this impressive milestone, the authoring senators released the following statements.

“The massive support for this legislation from Republicans and Democrats in both chambers of Congress, along with the more than 500 groups that have endorsed it, is proof that this is truly a good faith effort to make health care better for America’s seniors,” said Senator Marshall. “There’s a reason why the Improving Seniors’ Timely Access to Care Act is one of the most popular bills this Congress. Modernizing Medicare Advantage is the number one administrative hurdle for physicians and I can personally speak to these challenges as a physician myself and from my time managing Great Bend Regional Hospital. I’m grateful for all the hard work that has gone into creating significant momentum for this bill.”

“We’re proud our bipartisan bill modernizing and improving Arizona seniors’ access to timely health care has earned 500 endorsements – we’ll continue working to get our bipartisan legislation across the finish line,” said Senator Sinema.

“I’m proud to support this bipartisan legislation that makes health care delivery more efficient and patient-centered,” said Senator Thune. “By implementing electronic prior authorization, providers are able to reduce delays and help seniors in South Dakota get quicker access to the treatment and care they need.”

In addition to Senators Marshall, Sinema, Thune, and Brown, 34 senators have cosponsored this legislation. In the U.S. House of Representatives, the Improving Seniors’ Timely Access to Care Act was introduced by Representatives Suzan DelBene (WA), Mike Kelly (PA), Ami Bera, M.D. (CA), and Larry Bucshon, M.D. (IN), and has 302 cosponsors.

Recently Drs. Jonathan Crowe and David N. Bernstein praised Senator Marshall’s legislation in a FOX News Op-ed saying in part, “…U.S. Senator Dr. Roger Marshall’s Improving Seniors’ Timely Access to Care Act of 2021 is a bipartisan, bicameral bill with support in both chambers… By passing this legislation, Congress can send President Joe Biden a bill that creates a health system that is more efficient, less expensive, and focused on getting patients the care they need. His signature on this legislation would send a welcome message of support to patients and health care professionals. By taking these steps, we can move away from an outdated system that delays patient care and contributes to physician burnout. The lives of our nation’s patients and doctors may depend on it.”

You may click HERE for a full list of organizations that have announced support for the Improving Seniors’ Timely Access to Act.

Background:

Prior authorization is a tool used by health plans to reduce spending from improper payments and unnecessary care by requiring physicians and other health care providers to get pre-approval for medical services. But it’s not without fault. The current system of unconfirmed faxes of a patient’s medical information or phone calls by clinicians takes precious time away from delivering quality and timely care. Prior authorization continues to be the #1 administrative burden identified by health care providers and nearly four out of five Medicare Advantage enrollees are subject to unnecessary delays. In recent years, the Office of the Inspector General at the U.S. Department of Health and Human Services raised concerns after an audit revealed that Medicare Advantage plans ultimately approved 75% of requests that were originally denied.

Health plans, health care providers, and patients agree that the prior authorization process must be improved to better serve patients and reduce unnecessary administrative burdens for clinicians. In fact, leading health care organizations released a consensus statement to address some of the most pressing concerns associated with prior authorization. Building on these principles, the bipartisan legislation would:

• establish an electronic prior authorization process that would streamline approvals and denials;
• establish national standards for clinical documents that would reduce administrative burdens for health care providers and Medicare Advantage plans;
• create a process for real-time decisions for certain items and services that are routinely approved;
• increase transparency that would improve communication channels and utilization between Medicare Advantage plans, health care providers, and patients;
• ensure appropriate care by encouraging Medicare Advantage plans to adopt policies that adhere to evidence-based guidelines; and
• require beneficiary protections that would ensure the electronic prior authorization serves seniors first.

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