Kelly, Congressional Prior Authorization Champions Welcome New CMS Regulations

WASHINGTON, DC – Today, Representatives Mike Kelly (PA-16), Suzan DelBene (WA-01), Ami Bera, MD (CA-06), and Larry Bucshon, MD (IN-08), and Senators Roger Marshall, MD (KS), Sherrod Brown (OH), John Thune (SD), and Kyrsten Sinema (AZ) issued the following statement on CMS’ long-awaited prior authorization regulations:  

“Today’s action by CMS is a major win for seniors and their families. These new regulations will make a big difference in helping seniors access the medical care they are entitled to without unnecessary delays and denials due to prior authorization. The regulations will also enable health care providers to focus on delivering better care rather than wasting hours on the phone with insurance companies. While these regulations could have gone further, they will help bring the antiquated prior authorization system into the 21st century with commonsense changes like a streamlined approval process and increased transparency.

“Now, Congress must act to cement these gains into law by passing the overwhelmingly bipartisan, bicameral Improving Seniors’ Timely Access to Care Act to ensure seniors are getting the care they’re entitled to and reduce hours of unnecessary burden for physical practices and hospitals.”

BACKGROUND

In July 2023, the Ways and Means Committee passed the Kelly-led Improving Seniors' Timely Access to Care Act," legislation that would make it easier for seniors to get the care they need and improve health outcomes. The bill would modernize the antiquated prior authorization process in Medicare Advantage, which often still requires faxing documents to insurance companies.

You can watch Rep. Kelly's statement during the July 2023 committee hearing here.

The legislation would modernize and streamline the prior authorization process for the nearly 32 million Americans who are currently enrolled in Medicare Advantage. Previously, it received the endorsements of more than 500 organizations and was co-sponsored by more than 300 House members.