The House Ways and Means and Energy and Commerce Committees have advanced the Improving Seniors’ Timely Access to Care Act, H.R. 3514. The legislation would cement into law regulations issued by the Centers for Medicare and Medicaid Services (CMS) in 2024 that put in place important operational guardrails for how Medicare Advantage (MA) plans must administer prior authorization. H.R. 3514 makes many reforms permanent in law while adding new transparency, electronic standardization, and accountability measures.
During Ways and Means Committee consideration of the legislation, Greg Murphy, MD (R-NC) criticized the insurance industry for weaponizing prior authorization to their own profit and called United Healthcare the worst offender. “They create a bureaucracy that costs money, costs time and, in the end, causes patient harm.” He called on members of the Committee to pass H.R. 3514 and “take the fangs out of the insurance industry that has a stranglehold on this town.”
The legislation has the support of more than half the U.S. Congress and is endorsed by more than 300 organizations, including ASGE.
Passage of the legislation by the House Committees positions it for full House consideration.
The bill, as passed by the Energy and Commerce Committee, packages H.R. 3514 into a broader transparency bill that also requires greater transparency of prior authorization processes used by insurers offering group or individual health insurance coverage, including self-funded plans governed by ERISA (Employee Retirement Income Security Act).
ASGE members are encouraged to keep up advocacy efforts in support of the bill. Take action here.