Hirono backs bipartisan bill to speed up Medicare Advantage prior authorizations

US Sen. Mazie Hirono has announced she is backing bipartisan legislation aimed at improving access to medical care for seniors enrolled in Medicare Advantage plans by streamlining the prior authorization process.

Hirono joined Sens. Mark Warner, D-Va., Roger Marshall, R-Kan. and 44 colleagues in reintroducing the “Improving Seniors’ Timely Access to Care Act,” which they say would reduce delays in treatment and ease administrative burdens on health care providers.

“Seniors with Medicare Advantage plans should not have to endure unnecessary delays when seeking medical treatment, and sometimes even life-saving care,” Hirono said in a statement Friday. “This legislation will help to reduce these arbitrary waiting periods, streamlining prior authorization processes to ensure that health care providers can treat and care for their patients in an efficient manner.”

In Hawaiʻi, roughly 305,000 residents are enrolled in Medicare, and about 53 percent of them have Medicare Advantage plans.

The bill would:

• Require electronic prior authorization systems in Medicare Advantage plans;
• Standardize transactions and clinical documentation;
• Improve transparency around prior authorization use;
• Establish timeframes for expedited and real-time decisions;
• Expand patient protections and require agency reporting to Congress.

The legislation is supported by the Better Medicare Alliance, Humana and 138 other health care organizations.

Other cosponsors include Sens. Tammy Baldwin, D-Wis.; Marsha Blackburn, R-Tenn.; Richard Blumenthal, D-Conn.; Cory Booker, D-N.J.; John Boozman, R-Ark.; Ted Budd, R-N.C.; Maria Cantwell, D-Wash.; Shelley Moore Capito, R-W.Va.; Bill Cassidy, R-La.; Chris Coons, D-Del.; John Cornyn, R-Texas; Catherine Cortez Masto, D-Nev.; Tammy Duckworth, D-Ill.; Dick Durbin, D-Ill.; John Fetterman, D-Pa.; Deb Fischer, R-Neb.; Kirsten Gillibrand, D-N.Y.; Bill Hagerty, R-Tenn.; Maggie Hassan, D-N.H.; Josh Hawley, R-Mo.; Martin Heinrich, D-N.M.; John Hickenlooper, D-Colo.; John Hoeven, R-N.D.; Cindy Hyde-Smith, R-Miss.; Tim Kaine, D-Va.; Mark Kelly, D-Ariz.; Amy Klobuchar, D-Minn.; James Lankford, R-Okla.; Cynthia Lummis, R-Wyo.; Jeff Merkley, D-Ore.; Jerry Moran, R-Kan.; Patty Murray, D-Wash.; Alex Padilla, D-Calif.; Pete Ricketts, R-Neb.; Jacky Rosen, D-Nev.; Mike Rounds, R-S.D.; Rick Scott, R-Fla.; Jeanne Shaheen, D-N.H.; Tim Sheehy, R-Mont.; Tina Smith, D-Minn.; Thom Tillis, R-N.C.; Elizabeth Warren, D-Mass.; Peter Welch, D-Vt.; and Sheldon Whitehouse, D-R.I.

A companion bill was introduced in the US House by Reps. Ami Bera, D-Calif.; Suzan DelBene, D-Wash.; John Joyce, R-Pa.; and Mike Kelly, R-Pa.

The full text of the bill is available here.