The U.S. House of Representative Ways and Means Committee Today Advanced Crucial Legislation to Reform and Improve the Medicare Advantage Prior Authorization Process | SCAI
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Jul 27th 2022

The U.S. House of Representative Ways and Means Committee Today Advanced Crucial Legislation to Reform and Improve the Medicare Advantage Prior Authorization Process

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Interventional cardiologists praise Reps. Neal and Brady while calling on Congress to pass prior authorization reform

Washington, DC (July 27, 2022) The Society for Cardiovascular Angiography & Interventions (SCAI), the leading nonprofit medical society representing invasive and interventional cardiology, commends the U.S. House of Representatives Ways and Means Committee for advancing H.R. 3173, the Improving Seniors’ Timely Access to Care Act. The legislation reduces unnecessary delays in care by streamlining and standardizing prior authorization requirements in the Medicare Advantage program.

“SCAI applauds Chairman Richard Neal (D-MA-01) and Ranking Member Kevin Brady (R-TX-08) for passing the Improving Seniors’ Timely Access to Care Act out of committee,” said SCAI President Sunil V. Rao, MD, FSCAI. “Reforms from this legislation not only bring much-needed transparency to the prior authorization process, but they help streamline approvals in a way that we hope will reduce delays in care for Medicare Advantage patients.” 

The legislation was passed out of committee with bipartisan support and will remove bureaucratic red tape preventing many Medicare Advantage patients from receiving timely care. Specifically, the bill standardizes and streamlines the prior authorization process for routine services while creating a list of services eligible for real-time prior authorizations. Further, it will require prior authorization requests to be reviewed by qualified medical personnel, ensuring medical facts drive treatment and care decisions. Finally, the legislation creates an electronic prior authorization program for the Medicare Advantage prior authorization process while increasing program transparency.

"Opaque and burdensome prior authorization and pre-approval processes ultimately take the medical decision-making out of the hands of physicians, their staff, and their patients," said SCAI Trustee and Government Relations Committee Co-Chair Joaquin E. Cigarroa, MD, FSCAI. "This legislation is welcomed because it puts the medical decision-making process for heart patients back to where it should be, between interventional cardiologists and their patients."

SCAI Government Relations Committee Chair Lyndon Box MD, FSCAI, added that, "This legislation is a major step toward improving our healthcare system and ensuring that patients receive the best possible care. We now urge the full U.S. House of Representatives and the U.S. Senate to follow the bipartisan work of the House Ways and Means Committee and pass this bipartisan legislation to President Biden’s desk."

There are currently more than 300 bipartisan cosponsors of the Improving Seniors Timely Access to Care Act (H.R. 3173/S.3018), sponsored by Reps. Suzan K. DelBene (D-WA) and Mike Kelly (R-PA) and Senators Kyrsten Sinema (D-AZ) and Roger Marshall (R-KS) with more than 500 national and state patient, physician, health care professionals 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 endorsed the legislation.

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