MMA Supports Bill to Address Prior Auth by Medicare Advantage Plans

May 15, 2025

The MMA is once again endorsing the Improving Senior’s Timely Access to Care Act, a bipartisan piece of legislation that addresses the overuse and abuse of prior authorization (PA) by Medicare Advantage (MA) plans which threaten access to patient care and increase provider administrative burdens. 

The MMA supported this bill when it was introduced last year.  

If passed, the bill will:  

• Establish an electronic prior authorization (e-PA) process for MA plans including a standardization for transactions and clinical attachments.  

• Increase transparency around MA prior authorization requirements and their use.  

• Provide a pathway for CMS to institute real-time decisions for routinely approved items and services in the future and clarify CMS’ authority to establish timeframes for e-PA requests including expedited determinations, real-time decisions for routinely approved items and services, and any other PA request. 

• Expand beneficiary protections to improve enrollee experiences and outcomes.  

• Require HHS and other agencies to report to Congress on program integrity efforts and other ways to further improve the e-PA process.  

Since its introduction, more than 550 organizations like the MMA have endorsed the legislation.