MMA Supports Federal Legislation to Reform Prior Auth within Medicare Advantage

July 28, 2022

On July 26, the AMA sent a letter to the Chairman and Ranking Member of the Ways and Means Committee in support of H.R. 8487, the Improving Seniors’ Timely Access to Care Act of 2022. This bipartisan bill is important for reforming prior authorization (PA) processes within Medicare Advantage (MA). 

The MMA supports this legislation that, among other things, mandates MA plans to issue faster prior authorization decisions both for routinely approved services, as well as for all other services in Medicare Part C.  

The MMA and AMA have long been concerned about the PA process and its negative impact on patients. As highlighted by the 2021 AMA Prior Authorization survey, the AMA frequently hears from physicians and patients about delays in care that result from laborious PA insurer protocols.  

This legislation will help to standardize, streamline, and simplify PA within MA plans and improve the overarching timeliness of patient care while minimizing physician burden. The bill also provides much needed transparency within Medicare Advantage PA processes.