Washington, DC—Today, U.S. Congressman Henry Cuellar (TX-28) voted for H.R. 3171, the Improving Seniors’ Timely Access to Care Act. This bipartisan legislation, which I cosponsored, helps seniors get essential healthcare and improves health outcomes by cutting red tape. The bill modernizes the antiquated prior authorization process in Medicare Advantage, which still often requires doctors and patients to fax documents to insurance companies. 

Many Medicare Advantage plans require medical providers to have prior authorization for certain procedures before they can provide care to patients, which often leads to delays in care. This legislation will streamline the process and provide much-needed transparency for Medicare Advantage plans.

“Seniors in South Texas depend Medicare Advantage to maintain their health and get the care they need,” said Congressman Cuellar, a senior member of the House Appropriations Committee. “Slower care due to red tape with insurance companies takes the focus away from maintaining health. Today’s legislation modernizes this process, helping South Texas seniors get care more efficiently. I will always fight for our South Texas seniors.”

The bill would:

1. Establish an electronic prior authorization process.
2. Require the U.S. Department of Health & Human Services (HHS) to establish a process for “real-time decisions” for items and services that are routinely approved.
3. Improve transparency by requiring Medicare Advantage plans to report to the Centers for Medicare & Medicaid Services (CMS) on the extent of their use of prior authorization and the rate of approvals or denials.
4. Encourage plans to adopt prior authorization programs that adhere to evidence-based medical guidelines in consultation with physicians.

The bill now goes to the Senate for consideration, where it also has bipartisan support. 

A fact sheet on the Improving Seniors’ Timely Access to Care Act can be found here.

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