May 26, 2021
ASA Endorses HR 3173 to Address Prior Authorization Barriers
The American Society of Anesthesiologists (ASA) has endorsed H.R. 3173, the Improving Seniors’ Timely Access to Care Act, which would address prior authorization barriers. This bipartisan bill is targeted at modifying prior reauthorization requirements as it relates to health insurance for senior Americans, specifically, to help reduce the delays associated with accessing care in the Medicare Advantage (MA) program. Introduced by Representatives Suzan DelBene (D-WA-01), Mike Kelly (R-PA-16), Ami Bera, MD, (D-CA-07), and Larry Bucshon, MD (R-IN-08), this legislation was originally introduced last Congress and had bipartisan support by 91 cosponsors.
Prior authorization has long been utilized by insurance companies to determine if medication or surgery is necessary to a patient’s care, and if those services will be covered. The COVID-19 health crisis has made this process longer and caused delays in approval for many treatments. Even as the health care sector recovers from the pandemic, prior authorization has proven to be burdensome to seniors who are in need of life saving procedures and medication. The Improving Seniors’ Timely Access to Care Act of 2021 would:
- Establish an electronic prior authorization (ePA) program and require MA plans to adopt ePA capabilities;
- Require the Secretary of Health and Human Services to establish a list of items and services eligible for real-time decisions under an MA ePA program;
- Standardize and streamline the prior authorization process for routinely approved items and services;
- Ensure prior authorization requests are reviewed by qualified medical personnel;
- Increase transparency around MA prior authorization requirements and their use; and
- Protect beneficiaries from any disruptions in care due to prior authorization requirements as they transition between MA plans.
Until the Improving Seniors’ Timely Access to Care Act of 2021 is passed, anesthesiologists could continue to experience delays in providing quality care for vulnerable patients. ASA is pleased to endorse this bill with over 60 other medical organizations and thanks Representatives DelBene, Kelly, Bera and Buschon for introducing this legislation.
Read the bill text here.