For years, the Alliance of Specialty Medicine has advocated for reforms to the cumbersome prior authorization process that requires physicians to obtain pre-approval for medical treatments or tests before rendering care to their patients. Patients experience significant barriers to medically necessary care due to prior authorization requirements for items and services that are eventually routinely approved. This problem is especially acute in Medicare Advantage programs, and was the topic of a recent report by the Office of the Inspector General of the U.S. Department of Health and Human Services.
In the wake of this report, the House Energy and Commerce Committee’s Oversight Subcommittee convened a hearing entitled, “Protecting America’s Seniors: Oversight of Private Sector Medicare Advantage Plans.”
In a letter addressed to the bipartisan leadership of the full House Energy and Commerce Committee as well as the Oversight Subcommittee leadership, 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.
The letter to the Energy and Commerce Committee follows up on previous letters of support written to the bill’s House and Senate sponsors as well as OpEds authored by physicians describing their first-hand experience with the administrative burdens of prior authorization and how it can delay care and frustrate patients.