WASHINGTON – The Society for Cardiovascular Angiography & Interventions (SCAI), the leading nonprofit medical society representing invasive and interventional cardiology, today applauded the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) for a new report on the impact of prior authorizations on patient access to care in the Medicare Advantage program. The report, Some Medicare Advantage Organization Denials of Prior Authorization Requests Raise Concerns About Beneficiary Access to Medically Necessary Care, found that some Medicare Advantage plans are inappropriately denying beneficiaries access to care.  

“SCAI applauds HHS OIG for investigating the impact of burdensome prior authorizations on patient access to care in the Medicare Advantage program, and we support the OIG recommendations for Medicare officials to increase oversight and enforcement against plans with a track record of inappropriate denials,” said SCAI President Timothy D. Henry, MD, MSCAI. “More than 28 million older Americans rely on Medicare Advantage plans, the fastest growing segment of the Medicare program. Onerous prior authorization and pre-approval processes lead to potentially dangerous delays in patient care and create unnecessary burdens on physicians and their staff.” 

The most recent HHS OIG report comes on the heels of a 2022 Government Accountability Office (GAO) report on Medicare Advantage access challenges in mental health and a previous 2018 HHS report on the impact of preauthorization denials on patient access in Medicare Advantage.  

“We urge Congress to immediately pass the bipartisan Improving Seniors Timely Access to Care Act (H.R. 3173/S.3018), which would increase transparency and accountability, and to reduce the burdens of prior authorization in connection with Medicare Advantage plans,” added Henry.  

To date, there are 282 bipartisan cosponsors of the Improving Seniors Timely Access to Care Act (H.R. 3173/S.3018) and more than 400 national and state patient, physician, health care professional and other health care stakeholder organizations support the bill. SCAI is a member of the Regulatory Relief Coalition (RRC), a group of national physician specialty organizations that has also endorsed the legislation.