Key Senators Press CMS for Prior Authorization Reforms

This week, nearly 30 senators pressed the Centers for Medicare & Medicaid Services (CMS) for relief from prior authorization burdens, especially in Medicare Advantage plans. Led by two senior members of the Senate Finance Committee, Sens. Sherrod Brown, D-Ohio, and John Thune, R-S.D., they sent a letter urging CMS to address patients’ barriers to care.

The senators asked CMS Administrator Chiquita Brooks-LaSure to give an update on the agency’s “efforts to streamline prior authorization protocols.” They also urged her to implement the same reforms called for in the Improving Seniors’ Timely Access to Care Act. The Finance Committee oversees Medicare in the Senate.

The Regulatory Relief Coalition, an Academy-led group, asked Brown and Thune to lead the letter.

CMS already has the authority to make many of the changes called for in the Improving Seniors’ Timely Access to Care Act, including reforms like:

• Establishing an electronic, real-time prior authorization process
• Improving transparency around prior authorization requirements
• Increasing patient protections

In a related effort, Thune and Sens. Roger Marshall, MD, R-Kan., and Kyrsten Sinema, D-Ariz., reintroduced the Improving Seniors’ Timely Access to Care Act (S 3018) last week. A House companion bill (HR 3173) has already received strong bipartisan support with nearly 240 cosponsors. Use the Academy’s advocacy tool to urge your lawmakers to support S 3018 and HR 3173.

Prior authorization issues have been among the top complaints you and your colleagues have relayed to the Academy in recent years. We’ve heard you. That’s why we’ve made reducing administrative burdens and barriers to care one of our top advocacy priorities — and why we convened several other societies to launch the Regulatory Relief Coalition. We’ll continue to press for relief from these administrative burdens.