Colleagues-
PLEASE ACT NOW TO REFORM PRIOR AUTHORIZATIONS!
Congress has heard our demands for reforming the prior authorization process and will be voting on HR 3107 (details of bill below).
PLEASE Use the link below to write, email, and call your congressperson.
Using the link below, we emailed our representatives in less five minutes and included a personalized story. You can too!
Thanks,
Jason Reingold, MD, FACC
Pascha Schafer, MD, FACC
GA Advocacy and Regular Committee Chairs
Significant, bipartisan federal legislation was recently introduced that would provide necessary reforms to the prior authorization process. We urge you to ask your member of Congress to support the Improving Seniors’ Timely Access to Care Act of 2019 (H.R. 3107). The legislation would make several changes to items and services in Medicare Advantage plans. Specifically, the bill would:
- Create a “real-time” electronic prior authorization process, developed by the Secretary of HHS, for items and services that are routinely approved;
- Improve transparency by requiring plans to report to CMS on the extent of their use of prior authorization and the rate of approvals or denials;
- Require plans to adopt transparent prior authorization programs that are reviewed annually, adhere to evidence-based medical guidelines, and include continuity of care for individuals transitioning between coverage to minimize any disruption in care;
- Hold plans accountable for making timely prior authorization determinations and to provide rationales for denials;
- Prohibit additional prior authorization for medically-necessary services performed during a surgical or invasive procedure that already received, or did not initially require prior authorization.
The ACC has been a driving force behind the introduction of this legislation, working with the authors to ensure that this will make a series of positive reforms to improve patient care. It is our hope that this important step forward will bring about much needed changes to the prior authorization process.