MMA-Endorsed Prior Authorization Bill Passes U.S. House, Heads to U.S. Senate

September 15, 2022

On September 14, the U.S. House of Representatives unanimously passed the “Improving Seniors' Timely Access to Care Act” (H.R. 3173), a bill which reduces prior authorization (PA) burdens for physicians providing care to patients under Medicare Advantage (MA) plans.  

Specifically, the bill would require all MA plans to establish electronic PA programs, conform to a standardized PA process for the most routinely approved services (some of which must be considered for real-time decisions at the time of request), and ensure that all PA requests are reviewed by medical personnel. 

The MMA is one of more than 500 health-related organizations endorsing the legislation. According to the most recent data from the Centers of Medicare and Medicaid Services (CMS), approximately 506,405 Minnesotans are enrolled in MA plans, comprising around 48% of all Medicaid enrollees in the state.  

The MMA will continue to update its members on the progression of the bill. For further information, please contact Adrian Uphoff, MMA health policy analyst.