In a letter addressed to the lead sponsors, the Alliance of Specialty Medicine endorsed H.R. 3173, and S. 3018, the Improving Seniors’ Timely Access to Care Act. These bills would improve the prior authorization process in Medicare Advantage (MA) plans through increased transparency and the establishment of an electronic prior authorization process.
Prior authorization is a cumbersome process that requires physicians to obtain pre-approval for medical treatments or tests before rendering care to their patients. Patients are now experiencing significant barriers to medically necessary care due to prior authorization requirements for items and services that are eventually routinely approved. H.R. 3173 legislation will help streamline, standardize, and modernize prior authorization in the MA program.
Earlier this year, Dr. Richard Menger a neurosurgeon from Alabama authored an OpEd in the Hill newspaper offering first-hand experience on the administrative burdens associated with the current prior authorization process and how it can delay care and frustrate patients.