Members of the House and Senate have introduced "Dear Colleague" letters urging CMS to strengthen and finalize proposed rules to improve the prior authorization process for physicians and patients.
Due to overwhelming communications from individual physicians like you, the House and Senate sponsors were inundated with colleagues who wanted to sign-on—in fact, the response has been so great that the sponsors have extended the sign-on deadline to June 9!
The proposed rules align with many of the key provisions of the Improving Seniors' Access to Timely Care Act, which despite passing the House with over 300 cosponsors, and had strong bipartisan support in the Senate, failed to receive a vote on the Senate floor leaving millions of patients without these prior authorization protections they so desperately need.
These proposed rules would require Medicare Advantage plans to identify and issue real-time decisions for routinely approved services, adopt federally developed standardized electronic prior authorization processes, provide greater transparency surrounding the development and use of utilization management guidelines, and force them to provide rationales for denials.
As of May 19th, 39 bipartisan Senators and 120 bipartisan House members have already cosigned this important letter to the Department of Health and Human Services and Centers for Medicare and Medicaid Services related to these pending Medicare Advantage prior authorization regulations.