Kelly highlights need for Medicare Advantage Prior Authorization reform during Ways & Means hearing

WASHINGTON, D.C. -- Today, during a joint hearing of the Ways & Means Subcommittees on Health & Oversight, U.S. Rep. Mike Kelly (R-PA), a member of the Ways & Means Subcommittee on Health, renewed calls for Medicare Advantage Prior Authorization reform and highlighted his highly popular legislation, the bipartisan Improving Seniors’ Timely Access to Care Act.

"More than 33 million Americans, including more than 1.5 million Pennsylvanians, rely on Medicare Advantage as a part of their coverage. Patients, practitioners, and policymakers all agree -- modernization of the prior authorization process is long overdue, and my legislation does just that," said Rep. Kelly. "I am proud to reintroduce the Improving Seniors’ Timely Access to Care Act of 2025, which would move the health care sector into the 21st century by giving doctors and Medicare Advantage plans the tools to make health coverage decisions in a timely manner."

During Tuesday's hearing, which focused on Medicare Advantage, Kelly highlighted how the legislation would improve both patient costs and patient outcomes. Kelly's legislation has 145 co-sponsors in the U.S. House during the 119th Congress.

You can watch his remarks from Tuesday's hearing here.

BACKGROUND

The Improving Seniors’ Timely Access to Care Act would:

• Establish an electronic prior authorization process for MA plans including a standardization for transactions and clinical attachments.
• Increase transparency around MA prior authorization requirements and its use.
• Clarify HHS’ authority to establish timeframes for e-prior authorization requests including   expedited determinations, real-time decisions for routinely approved items and services, and other prior authorization requests.
• 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.
• Previously, Rep. Kelly led similar legislation in the 118th Congress. The Improving Seniors’ Timely Access to Care Act unanimously passed the House in the 117th Congress and was cosponsored by a majority of members in the Senate and House of Representatives. 

You can read the full bill text here and a section-by-section here.