What They Are Saying: Overwhelming Support For Senator Marshall’s Prior Authorization Reform Bill

Washington, D.C. – Earlier this month, U.S. Senator Roger Marshall, M.D. (R-KS), Kyrsten Sinema (I-AZ), John Thune (R-SD), Sherrod Brown (D-OH), and U.S. Representatives Mike Kelly (R-PA), Suzan DelBene (D-WA), Larry Bucshon, M.D. (R-IN) and Ami Bera, M.D. (D-CA) introduced theImproving Seniors’ Timely Access to Care Act. The bipartisan, bicameral legislation streamlines the prior authorization process under Medicare Advantage (MA), allowing seniors to get the care they need while helping health care providers put patients over paperwork. 

Since its introduction, the legislation has continued to gain support and is now backed by over 400 national and state organizations representing patients, physicians, MA plans, hospitals, and other key stakeholders in the health care industry.  

See below to see what some organizations are saying about the Improving Seniors’ Timely Access to Care Act.

“We are honored to work with the Regulatory Relief Coalition (RRC), the lead organization comprised of national physician specialty organizations that are working with bill champions on this critically important legislation,” said Peggy Tighe, Principal at Powers Law. “RRC helped craft the legislation in 2018, moved it through committees and passage on the House floor in the last two Congresses, encouraged the Administration to finalize rules mirroring the legislation in January of this year, and is working in earnest to help Congress pass this bill this year. This bipartisan, bicameral, non-controversial, and widely supported legislation is one of the most widely supported health care bills in the 118th Congress.”

“We fully endorse this legislation and want to thank Senator Marshall for sponsoring its re-introduction,” said Rachel Monger, President and CEO of LeadingAge Kansas. “This legislation removes unnecessary barriers that prevent seniors from accessing timely healthcare. It alleviates burdens faced by seniors and their families during challenging transitions. It is a crucial step toward ensuring our older population receives the care they need, when and where they need it.”

“The Seniors Timely Access to Care Act addresses one of the main concerns providers have regarding Medicare Advantage plans: slow prior authorization approvals,” said Chad Austin, President and CEO of the Kansas Hospital Association. “Greater transparency in MA plans’ prior authorization processes and a streamlined method for approvals will help clinicians provide appropriate and timely care and, most importantly, improve patient outcomes. We applaud Senator Marshall and the bill’s cosponsors for working to address this critical issue.”

“This legislation addresses one of the most common issues we hear about from our beneficiary network and ally groups. Prior authorization is an important tool in Medicare Advantage, and it is vital that we streamline this process for seniors,” said Mary Beth Donahue, President and CEO of Better Medicare Alliance. “We thank Senators Marshall, Sinema, Thune, and Brown, and Representatives DelBene, Kelly, Bera, and Bucshon for their leadership. With more than 33 million seniors now choosing Medicare Advantage, this work is more urgent and necessary than ever. We are pleased to join with hundreds of national organizations in support of this bill.”

“The current Medicare Advantage prior authorization process obstructs appropriate care for patients and is a drain on limited resources for facilities and providers,” said Alan Morgan, CEO, the National Rural Health Association. “This is especially true in rural facilities, where a shortage of staff means that time spent processing and negotiating prior authorizations is time that could otherwise be spent providing patient care. The National Rural Health Association is grateful to Senator Marshall for introducing legislation which will update, clarify, and add transparency to this process for the benefit of rural patients.”  

“For those undergoing treatment for breast cancer, unnecessary delays caused by burdensome prior authorization requirements can be costly to both the patient and the health care system,” said Molly Guthrie, Susan G. Komen’s Vice President of Policy and Advocacy. “We proudly support the Improving Seniors’ Timely Access to Care Act and applaud the bill sponsors’ efforts to protect patients by setting necessary guardrails for prior authorization use in Medicare Advantage. We urge Congress to act swiftly to remove barriers to patients accessing the care they need when they need it.”

“As President of the AMAC Action, I am proud to support the Improving Seniors’ Timely Access to Care Act (S.4532 H.R. 4532),” said Bob Carlstrom, President and CEO of the Association of Mature American Citizens. “This crucial legislation will streamline the prior authorization process under Medicare Advantage, ensuring that our members receive the medical services they need without unnecessary delays. By removing bureaucratic obstacles, this act will significantly enhance the quality of care for millions of seniors, providing timely access to treatments and improving overall health outcomes. We commend the bipartisan effort behind this initiative and urge Congress to pass this important legislation for the well-being of our senior community.” 

“The current prior authorization process creates frustrating administrative roadblocks for patients and providers. The bipartisan Improving Seniors’ Timely Access to Care Act, would promote electronic prior authorization and streamline access to care in the Medicare Advantage program. It is a breath of fresh air for everyone who has ever tried to navigate this complicated process,” said Hal Wolf, President & CEO of the Healthcare Information and Management Systems Society (HIMSS). “HIMSS looks forward to working with the Senate and House sponsors of this legislation to get this critical piece of administrative simplification signed into law.  Our mutual goal is to reduce an unnecessary burden in healthcare that will benefit patients and health systems alike.”

“We thank the sponsors for writing the bill so it will attract even more support. We came close last Congress to passing this much-needed reform. Our patients know all too well that prior authorization needs a dramatic overhaul. We think this is the year to get this bill over the finish line,” said Bruce A. Scott, M.D., President of the American Medical Association.

“With more than 33 million Medicare Advantage beneficiaries nationwide, the Improving Seniors’ Timely Access to Care Act is a big win for patients and physicians alike,” said Joseph Alhadeff, MD, President of Physician-Led Healthcare for America. “Every day, in small towns and large cities, the prior authorization process not only prevents seniors from getting the care they need, but also buries physicians in a deluge of bureaucratic red tape. In fact, there’s no bigger obstacle to the patient-physician relationship than prior authorization—which is tantamount to practicing medicine without a license. That’s why we strongly support this legislation’s reforms to prior authorization. By increasing transparency, establishing new electronic systems, and enabling CMS to enforce more timely decisions, it will help empower physicians to do what they do best: take care of their patients. What’s more, the CBO projects that the share of all Medicare beneficiaries enrolled in Medicare Advantage will jump from 51% today to 62% by 2033. With this in mind, we applaud the Senate and House sponsors for taking such decisive action now. It’s a much-needed fix to one of the most broken pieces of our healthcare delivery system.”

“The AHA greatly appreciates the leadership from this bipartisan group of Senators and Representatives to reintroduce vital legislation to streamline the broken prior authorization process in the Medicare Advantage program,” said Stacey Hughes, executive vice president at the American Hospital Association. “By removing unnecessary barriers that create delays in treatment, this meaningful bill will improve access to care for seniors and allow caregivers to spend more valuable time at the bedside with patients and less time on burdensome paperwork.”

“The National Association for Home Care & Hospice wholeheartedly endorses the bipartisan, bicameral Improving Seniors’ Timely Access to Care Act,” said William Dombi, President and CEO of the National Association for Home Care & Hospice. “For too long, enrollees and providers of health care in patients’ homes have had to endure untimely, burdensome, unreliable, and oftentimes erroneous prior authorization processes. The Act will go a long way to rectifying these concerns and protecting seniors when they need essential health care.  We call on Congress to pass this legislation now.”

“Thank you for improving timely access to care for those navigating difficult treatment decisions,”said Steve Hentzen, Co-Founder of the Prostate Network. “Our men need and deserve it.”

“Free2Care is dedicated to advocating for timely and effective healthcare for all, including seniors, and we strongly support the bipartisan Improving Seniors’ Timely Access to Care Act,” said Josephine Gallagher, Executive Director of Free2Care. “Delays in care due to cumbersome prior authorization processes under Medicare Advantage can have life-threatening and even fatal consequences. This critical legislation will modernize these processes, ensuring that seniors receive the medical services they need without unnecessary delays. The passage of this act is essential to safeguard the health and well-being of our elderly population. We urge legislators to act swiftly in support of this vital initiative.” 

“By reining in managed care plans’ unrestrained use of prior authorization, this legislation will both increase older adults’ access to much-needed care and ensure that providers can devote their attention to providing that care — rather than spending valuable time and energy emailing and uploading mounds of documentation to plans only to have requests denied. We applaud Senator Marshall (R-KS), Representative Kelly (R-PA) and the nearly 180 bipartisan cosponsors for taking on plans’ overuse and abuse of prior authorizations and, by doing so, restoring accountability and transparency around prior authorization practices. Positive change is urgently needed; the Improving Seniors’ Timely Access to Care Act (S.4532 and HR 8702) will achieve it,” said Katie Smith Sloan, President and CEO of LeadingAge.