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Cosponsors Bipartisan Measure that Proposes Changes to Prioritize Patients Over Paperwork
WASHINGTON, D.C. – U.S. Senator Cindy Hyde-Smith (R-Miss.) late last week cosponsored legislation that would result in allowing Medicare beneficiaries to get the care they need faster and to help health care providers prioritize patients over paperwork.
The bipartisan Improving Seniors’ Timely Access to Care Act (S.4532) would streamline the prior authorization process under Medicare Advantage (MA) to ensure patients can access medical services in a timely manner. Health care providers identify prior authorization requirements as a leading cause of administrative burden.
“Streamlining the paperwork burden, which this bill aims to do, would benefit both seniors with Medicare Advantage coverage who need timely access to care and the health care providers who are overwhelmed by paperwork demands. The current system is unfair to both and should be improved, posthaste,” Hyde-Smith said.
MA prior authorization is a tool used by health plans that requires providers to get pre-approval for medical services. This process often results in communication lapses between clinicians and insurance companies and longer wait times for patients.
U.S. Senator Roger Marshall, M.D. (R-Kan.) introduced S.4532, which would enable health care professionals to better serve patients and reduce unnecessary administrative burdens by:
- Establishing an electronic prior authorization process for MA plans including a standardization for transactions and clinical attachments.
- Increasing transparency around MA prior authorization requirements and its use.
- Clarifying the Centers for Medicare and Medicaid Services’ authority to establish timeframes for electronic prior authorization requests, including expedited determinations, real-time decisions for routinely approved items and services, and other prior authorization requests.
- Expanding beneficiary protections to improve enrollee experiences and outcomes.
- Requiring the U.S. Department of Health and Human Services and other agencies to report to Congress on program integrity efforts and other ways to further improve the electronic prior authorization process.
Health care professionals in Mississippi and the nation have experienced an increase in burnout following the COVID-19 pandemic, and high administrative burdens are a direct contributing factor, according to a 2022 U.S. Surgeon General report.
The Mississippi State Medical Association, Mississippi Oncology Society, and Mississippi Academy of Eye Physicians and Surgeons are among the nearly 400 national, regional, state, and district organizations that have endorsed the bill.
Hyde-Smith is among 44 original cosponsors, which includes U.S. Senators Kyrsten Sinema (I-Ariz.), John Thune (R-S.D.), Sherrod Brown (D-Ohio), Marsha Blackburn (R-Tenn.), Sheldon Whitehouse (D-R.I.), Bill Cassidy, M.D. (R-La.), Maggie Hassan (D-N.H.), Thom Tillis (R-N.C.), Tom Carper (D-Del.), John Cornyn (R-Texas), Bob Casey (D-Pa.), John Boozman (R-Ark.), Debbie Stabenow (D-Mich.), Jerry Moran (R-Kan.), Amy Klobuchar (D-Minn.), J.D. Vance (R-Ohio), Kirsten Gillibrand (D-N.Y.), Ted Budd (R-N.C.), Tim Kaine (D-Va.), Josh Hawley (R-Mo.), Jeanne Shaheen (D-N.H.), Mark Kelly (D-Ariz.), Kevin Cramer (R-N.D.), Jacky Rosen (D-Nev.), Mike Braun (R-Ind.), Martin Heinrich (D-N.M.), Eric Schmitt (R-Mo.), John Hickenlooper (D-Colo.), Marco Rubio (R-Fla.), Gary Peters (D-Mich.), Mike Rounds (R-S.D.), Peter Welch (D-Vt.), John Hoeven (R-N.D.), Alex Padilla (D-Calif.), Richard Blumenthal (D-Conn.), Raphael Warnock (D-Ga.), Brian Schatz (D-Hawaii), Jeff Merkley (D-Ore.), John Fetterman (D-Pa.), and Elizabeth Warren (D-Mass.). Companion legislation has also been introduced in the U.S. House of Representatives.
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