Improving Seniors’ Timely Access to Care Act of 2021

Improving Seniors' Timely Access to Care Act of 2022

This bill establishes several requirements and standards relating to prior authorization processes under Medicare Advantage (MA) plans.

Specifically, MA plans must (1) establish an electronic prior authorization program that meets specified standards, including the ability to provide real-time decisions in response to requests for items and services that are routinely approved; (2) annually publish specified prior authorization information, including the percentage of requests approved and the average response time; and (3) meet other standards, as set by the Centers for Medicare & Medicaid Services, relating to the quality and timeliness of prior authorization determinations.

Bill 117 HR 3173, also known as the Improving Seniors' Timely Access to Care Act of 2021, aims to address issues related to Medicare's current prior authorization process for medical services. The bill seeks to streamline and improve the prior authorization process in order to ensure that seniors have timely access to necessary medical care.

The bill specifically targets the prior authorization process for Medicare Advantage plans, which are private insurance plans that provide Medicare benefits. Currently, the prior authorization process for these plans can be time-consuming and burdensome for both healthcare providers and patients, leading to delays in care and potentially harmful outcomes.

Under the Improving Seniors' Timely Access to Care Act of 2021, Medicare Advantage plans would be required to implement electronic prior authorization processes, which are expected to be more efficient and less burdensome than the current manual processes. The bill also includes provisions to standardize prior authorization requirements across different Medicare Advantage plans, which would help to reduce confusion and streamline the process for healthcare providers. Overall, the goal of Bill 117 HR 3173 is to improve seniors' access to timely medical care by making the prior authorization process more efficient and less burdensome. By streamlining this process, the bill aims to ensure that seniors receive the care they need in a timely manner, ultimately improving their health outcomes and quality of life.