Health plan prior authorization change bill returns to Senate
The bill would establish a standardized electronic prior authorization process for Medicare Advantage plans, and it could serve as a model for new rules for employer plans.
A health insurance bill that had strong, bipartisan support two years ago has now returned to the Senate.
Four senators have reintroduced the Improving Seniors’ Timely Access to Care Act bill.
The senators say the bill will improve the prior authorization process health insurers use to review controversial or expensive care. It would create a standardized electronic prior authorization process for Medicare Advantage plans plan enrollees.
The bill would have no direct effect on the employer-sponsored health plan market, but it could serve as a model for new rules for employer plans.
The version of the bill introduced in 2021 died in committee, but that version attracted a list of cosponsors that included 52 U.S. senators and 326 members of the U.S. House.
The lead sponsors of the new bill are Sen. Sherrod Brown, D-Ohio; Sen. Roger Marshall, R-Kan.; Sen. Sherrod Brown, R-Ohio, and Sen. Kyrsten Sinema, an independent from Arizona.
The list of supporters includes many medical groups, such as the American Medical Association.
Related: AMA wants legal consequences for prior authorization delays that hurt patients
The list of supporters also includes the Better Medicare Alliance, a group with strong ties to Medicare plan providers.
Insurer groups, including America’s Health Insurance Plans and the Blue Cross Blue Shield Association, have long argued that prior authorization procedures can be approved but that well-designed prior authorization procedures can help hold down the cost of care and improving the quality.