Newswise — The Regulatory Relief Coalition (RRC), a group of national physician specialty organizations, announced its strong support for the Improving Seniors' Timely Access to Care Act, legislation introduced today in the U.S. Senate by Senators Sherrod Brown (D-OH) and John Thune (R-SD).

The coalition is particularly pleased to support this bipartisan legislation because it would reform the use of prior authorization in Medicare Advantage (MA) through a streamlined and standardized process that focuses on increased transparency.  The bill is a common-sense solution that would call on the Secretary of the U.S. Department of Health and Human Services to:

  • Establish a real-time, electronic prior authorization process;
  • Minimize the use of prior authorization for routinely approved services;
  • Ensure prior authorization requests are reviewed by qualified medical personnel;
  • Require transparency through regular reporting from MA plans on their use of prior authorization, as well as rates of delay and denial of services, and for determinations that occur in the context of surgeries or other invasive procedures.

Especially during the current COVID-19 crisis, when many patients have already delayed needed care and providers are often working with reduced staff, it is critical to reduce unnecessary burdens and roadblocks in the health care system that weaken beneficiaries' timely access to care. 

The RRC has been advocating for this legislation even before the introduction of the House companion legislation, H.R. 3107, in June of 2019.  The House bill has garnered nearly 280 bipartisan co-sponsors and over 400 endorsing organizations in just the last year and a half.  The coalition anticipates similar support in the Senate and looks forward to advancing the legislation at the earliest possible opportunity. 

“Ophthalmologists have told the Academy that prior authorization requirements can have tremendous impact on patient care by preventing timely access to necessary medical care,” said David Glasser, MD, Secretary of Federal Affairs of the American Academy of Ophthalmology.  “We applaud Senators Sherrod Brown and John Thune for introducing legislation to protect America’s seniors from unnecessary barriers.”

Ann R. Stroink, MD, FAANS, a practicing neurosurgeon from Bloomington, Illinois, and chair of the AANS/CNS Washington Committee, said, “Neurosurgeons like take care of very sick patients who suffer from painful and life-threatening neurologic conditions such as brain tumors, debilitating, degenerative spine disorders and Parkinson’s Disease, and they cannot afford to wait or jump through unnecessary hoops to get their life-saving care. We are grateful to Senators Brown and Thune for taking this important step to improve prior authorization for our nation’s seniors.”

Members of the RRC coalition include the American Academy of Neurology, American Academy of Ophthalmology, American Association of Neurological Surgeons, American Association of Orthopaedic Surgeons, American College of Cardiology, American College of Rheumatology, American College of Surgeons, American Gastroenterological Association, Association for Clinical Oncology, Congress of Neurological Surgeons, National Association of Spine Specialists, and the Society for Cardiovascular Angiography and Interventions.

 

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