Better Medicare Alliance Endorses Bipartisan Legislation to Modernize Prior Authorization for Seniors

Washington, D.C.  – Better Medicare Alliance, the nation’s leading research and advocacy organization supporting Medicare Advantage, announced its endorsement of H.R. 3173, the Improving Seniors’ Timely Access to Care Act.

The bipartisan legislation, sponsored by Reps. Suzan DelBene (D-WA), Mike Kelly (R-PA), Ami Bera, MD (D-CA), and Larry Bucshon, MD (R-IN), would modernize the way Medicare Advantage uses prior authorization as a clinical tool to coordinate beneficiaries’ care.

“When it comes to the use of medical management tools like prior authorization, Better Medicare Alliance has always worked on two tracks: seeking to increase understanding about the role of prior authorization in facilitating high-value, clinically appropriate care, while also working to simplify this process for patients and providers alike,” said Mary Beth Donahue, President and CEO of the Better Medicare Alliance. “The Improving Seniors’ Timely Access to Care Act is a commonsense solution that builds on the work the Medicare Advantage community has been doing to streamline prior authorization for seniors. With Medicare Advantage already delivering nearly $2,000 in annual savings to consumers and lower per-beneficiary spending for taxpayers, this is another way that Medicare Advantage can continue to raise the bar in the delivery of affordable, accessible coverage and care. We are pleased to support this bipartisan measure and look forward to working with CMS, the provider community, and other stakeholders to facilitate a smooth adoption and transition to electronic prior authorization protocols.”

“Our legislation will bring prior authorization into the 21^st Century, leveraging the latest technology to improve Medicare Advantage and health outcomes. We welcome the Better Medicare Alliance’s support of these reforms and look forward to working with them to get this bill signed into law,” said Reps. Suzan DelBene (WA-01), Mike Kelly (PA-16), Ami Bera, M.D. (CA-07), and Larry Bucshon, M.D. (IN-08), lead sponsors of the House bill. 

“Vancouver Clinic is proud to join Better Medicare Alliance in supporting the Improving Seniors’ Timely Access to Care Act. We thank the lead House sponsor, Rep. Suzan DelBene, and her colleagues for the many ways this bipartisan bill will help seniors right here in Washington state,” said Mark Mantei, CEO of the Vancouver Clinic. “We value our partnership with Medicare Advantage to serve beneficiaries across more than a dozen clinic locations in Washington and Oregon. This bipartisan bill will help providers like ours continue to deliver the timely, compassionate care these seniors have come to know and expect.” 

“Arizona nurses know firsthand the value of Medicare Advantage to the communities we serve. We also know that our health care system can do more to place prior authorization on the side of the patient; adopting new standards and fostering improved technology that will better serve our seniors. This bill will help accomplish exactly that. We join Better Medicare Alliance in offering our full support and calling for its immediate passage,” said Heather Ross, PhD, DNP, ANP-BC, FAANP, Governmental Affairs Officer for the Arizona Nurses Association. 

“The Coalition of Texans with Disabilities is proud to stand alongside Better Medicare Alliance as we work to protect the innovations in Medicare Advantage that are leading to higher satisfaction, better benefits, and lower consumer costs while also supporting smart public policy solutions like this bipartisan bill to simplify prior authorization for beneficiaries,” said Dennis Borel, Executive Director of the Coalition of Texans with Disabilities. “We thank the bill sponsors for their leadership on this measure that ensures every Medicare Advantage enrollee managing a disability will continue to stay healthy by having timely access to the care they need.”

Further Reading on Medicare Advantage’s Use of Prior Authorization to Deliver Quality, Affordable Care for Seniors:

• BMA blog post: “A Deeper Dive on Prior Authorization in Medicare Advantage” (May 2022)
• BMA Fact Sheet: “Prior Authorization in Medicare Advantage” (May 2022)

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