WTAS: Marshall, Sinema, Thune Working to Prioritize Patients over Paperwork

(Washington, D.C., October 29, 2021) – U.S. Senators Roger Marshall, M.D. (R-KS), Krysten Sinema (D-AZ), and John Thune (R-SD) introduced the Improving Seniors’ Timely Access to Care Act, bipartisan legislation that would improve timely access to quality care for seniors under Medicare Advantage. Specifically, the bill would modernize the way Medicare Advantage plans and health care providers use prior authorization. This legislation has amassed support from over 320 national and state organizations representing patients, health care providers, medical device manufacturers, and health IT companies across the country.

Here is what they are saying about this legislation that addresses the number one administrative issue for physicians today:

“The bill is a carefully crafted, bipartisan work product that reflects significant input from all direct stakeholders,” said Katie Orrico, SVP for Health Policy and Advocacy at the American Association of Neurological Surgeons/Congress of Neurological Surgeons and leader of the Regulatory Relief Coalition. “The congressional team behind this bill focused on transparency, oversight, and modernization of the Medicare Advantage program to benefit patients and the providers and health plans who serve them. We eagerly await congressional action.  The bill is ready for the finish line.”

“Physicians know the best treatment for our patients but they’re often not the ones making the final decision due to artificial barriers constructed by insurance companies,” said American Medical Association President Gerald E. Harmon, M.D. “The time delays and administrative burdens associated with prior authorization continue to undermine our patients’ health. Nearly a third of physician respondents to a 2020 AMA survey reported that prior authorization led to a serious adverse event — such as hospitalization, medical intervention to prevent permanent impairment, or even disability or death — for a patient in their care. The AMA thanks Senators Marshall, Sinema, and Thune for putting patients first by introducing the Improving Seniors’ Timely Access to Care Act, which would simplify and streamline the prior authorization processes in Medicare Advantage.”

“Hospitals and health systems strongly support the Improving Seniors’ Timely Access to Care Act because physicians, nurses and other providers of care should be able to spend their time on patients, not burdensome paperwork,” said Stacey Hughes, executive vice president at the American Hospital Association. “Efforts to streamline and standardize prior authorization are long overdue. Used appropriately, prior authorization can be a helpful tool for ensuring patients receive the right treatment, but too often the process results in delayed care, clinician burnout and unnecessary waste in the health care system. The AHA is eager to continue to work with Senators Marshall, Sinema and Thune to make improvements to the prior authorization process that protect patients.” 

“NCCN is proud to support the Improving Seniors’ Timely Access to Care Act,” said Robert W. Carlson, MD, Chief Executive Officer of the National Comprehensive Cancer Network. “This legislation offers sensible reforms to ensure America’s seniors can access evidence-based, high quality care in a timely fashion. As a developer of nationally-recognized clinical practice guidelines used in real-time prior authorization tools, NCCN knows firsthand that real-time electronic prior authorization, based on evidence, can significantly reduce unnecessary delays in cancer care while also saving money. This legislation would ensure that Medicare Advantage beneficiaries don’t have to wait for the care they need.”

“The American Osteopathic Association is pleased to support the Improving Seniors’ Timely Access to Care Act,” said Joseph A. Giaimo, DO, MACOI, FCCP, president of the American Osteopathic Association. “This legislation is an important first step in improving transparency and unnecessary delays in access to care for patients, while simultaneously reducing physician and administrative prior authorization burdens.”

“Passage of the Improving Seniors’ Timely Access to Care Act would be a giant step forward in having Medicare Advantage plans use 21st Century prior authorization processes,” said Blair Childs, Senior Vice President of Public Affairs for Premier.  “Today’s processes are manual, burdensome and costly.  Continuing to use manual and paper based processes contributes to care delays, and there evidence that current approaches cause patient harm. Premier commends the sponsors of the legislation for your leadership and urges the Senate and House to act quickly on this bipartisan, bicameral legislation.”

“The Coalition of Long-Term Acute-Care Hospitals strongly supports S. 3018, which would ensure that Medicare patients receive timely access to necessary care and protect those patients from harm caused by unnecessary bureaucratic delays,” said Anthony Misitano, Chair of the Coalition of Long-Term Acute-Care Hospitals. 

CBS Topeka: Sen. Marshall working to prioritize patients over paperwork

American Medical Association: In 2020 AMA survey, 94% of physicians saw care delays with patients waiting for needed care & 79% of physicians saw patients stop treatment due to #priorauth. We thank @RogerMarshallMD @SenatorSinema @SenJohnThune for introducing the Improving Seniors’ Timely Access to Care Act.

American Hospital Association: AHA applauds @RogerMarshallMD @SenatorSinema @SenJohnThune Senate bill on prior authorization for Medicare Advantage: “Physicians, nurses and other providers of care should be able to spend their time on patients, not burdensome paperwork.” #fixpriorauth

American Association of Neurological Surgeons: TY @RogerMarshallMD @SenatorSinema and @SenJohnThune for introducing #S3018, the Improving Seniors’ Timely Access to Care Act, which will ensure timely access to quality care for seniors with #Medicare Advantage. Read more: https://bit.ly/3E2OBXt #FixPriorAuth

Alliance for Specialty Medicine: We have a Senate companion to the #fixpriorauth bill!  The current Prior Authorization process has run amok causing doctors to deal with more bureaucracy rather than caring for patients.  Read our letter of support of S.3018. Let’s get this bill passed! https://bit.ly/3G9Nkjd

American Geriatrics Society: @AmerGeriatrics supports the Improving Seniors’ Timely Access to Care Act which would protect patients from unnecessary delays in care by improving the #priorauth process. We appreciate @RogerMarshallMD @SenatorSinema @SenJohnThune for reintroducing the bill.

Medical Device Manufacturers Association: MDMA thanks @RogerMarshallMD, @SenatorSinema, and @SenJohnThune for their bipartisan leadership in working to address the ongoing adverse impact that the ‘prior authorization’ process is having on patient care. #fixpriorauth

Arthritis Foundation: A new bill was just introduced in the Senate! #S3018, the Improving Seniors’ Timely Access to Care Act, aims to #fixpriorauth for seniors on Medicare Advantage plans. This is a companion to #HR3173 introduced earlier this year. #AdvocateforArthritis

American Academy of Otolaryngology—Head and Neck Surgery: Thank you @RogerMarshallMD, @SenatorSinema and @SenJonThune for your leadership in taking steps to reduce the burden of #priorauth. Let’s work to pass the Improving Seniors’ Timely Access to Care Act NOW –  it’s time to put patient & physician needs first! #fixpriorauth

American Society of Clinical Oncology: Urge your lawmakers to support the Improving Seniors’ Timely Access to Care Act, which was introduced in the Senate today. This bill would help address care delays due to burdensome prior authorization practices. https://fal.cn/3jcrq #FixPriorAuth #ASCOAdvocacy

American Medical Rehabilitation Providers Association: AMRPA applauds the bipartisan introduction of the Improving Seniors’ Timely Access to Care Act. We thank @RogerMarshallMD, @SenatorSinema & @SenJohnThune for introducing this first step in addressing prior auth issues. Read our statement: https://bit.ly/3joaVDa #FixPriorAuth

American Society for Radiation Oncology: The Improving Seniors’ Timely Access to Care Act, aims to take the first step at fixing #PriorAuthorization requirements that create treatment delays & put undue burden on patients/providers. Visit http://astro.org/advocate to ask your rep to co-sponsor the bill. #FixPriorAuth

Federation of America’s Hospitals: Many #MedicareAdvantage Plans use #PriorAuth to delay or deny care patients need. Bipartisan Improving Seniors’ Timely Access to Care Act will help #fixpriorauth issues. Appreciate @RogerMarshallMD, @SenatorSinema & @SenJohnThune for introducing bill

American Society for Gastrointestinal Endoscopy: ASGE ? @RogerMarshallMD @SenatorSinema @SenJohnThune for reintroduction of the Improving Seniors’ Timely Access to Care Act, #S3108. With a majority of the House supporting companion #HR3173, Congress should be compelled to act this year to #FixPriorAuth. #GITwitter #medtwitter

Pennsylvania Chapter of the American College of Cardiology: We support S. 3108, the Improving Seniors’ Timely Access to Care Act of 2021 that has been introduced to address #accesstocare and fix #priorauth @RogerMarshallMD @SenatorSinema @SenJohnThune @Cardiology @ACCinTouch

Virginia Chapter of the American College of Cardiology: Join us to support S. 3108, the Improving Seniors’ Timely Access to Care Act of 2021 introduced to address #accesstocare and fix #priorauth @RogerMarshallMD @SenatorSinema @SenJohnThune @Cardiology @ACCinTouch

Maryland Chapter of the American College of Cardiology: News on #priorauth! S. 3108, the Improving Seniors’ Timely Access to Care Act of 2021 has been introduced to reform #accesstocare @RogerMarshallMD, @SenatorSinema @SenJohnThune @Cardiology @ACCinTouch

Florida Chapter of the American College of Cardiology: Great News on #priorauth! A Senate bill has been introduced to reform #accesstocare @RogerMarshallMD, @SenatorSinema @SenJohnThune

Patients and Physicians: RT PPA_USA: RT @mass_marion: Thank you, @RogerMarshallMD @SenatorSinema @SenJohnThune @RepDelBene @MikeKellyPA @RepBera @RepLarryBucshon for reforming #priorauth with the Improving Seniors’ Timely Access to Care Act. time to #cuttheglut of regulation!

Free2Care: A great bipartisan bill! ‘Hospitals and health systems strongly support the Improving Seniors’ Timely Access to Care Act because physicians, nurses and other providers of care should be able to spend their time on patients, not burdensome paperwork,’

Patients Rising: Thank you! @RogerMarshallMD @SenJohnThune @SenatorSinema #fixpriorauth

Chip Kahn, President and CEO, Federation of American Hospitals: Patient & physicians should decide on medically necessary care not #MA plans. #Bipartisan bill aims at fixing #PriorAuth abuses denying/delaying care. Improving Seniors’ Timely Access to Care Act from @RogerMarshallMD @SenatorSinema & @SenJohnThune (1/2). @FAHhopitals, other joins fellow associations supporting goal to #fixpriorauth & “put patients over paperwork” by protecting beneficiaries & ensuring access. (2/2)

Marilyn J. Heine, MD, FACP, FACEP, is chair on the Council on Legislation at the American Medical Association: TY @RogerMarshallMD @SenatorSinema @SenJohnThune on Improving Seniors’ Timely Access to Care Act • timely access to quality care for seniors w/Medicare Advantage • help #fixpriorauth • require insurers follow agreed-to principles: https://tinyurl.com/3ykz3xvw

Kathleen Teixeira, Vice President of Public Policy and Government Affairs, American Gastroenterological Association: Finally! The Senate #priorauth bill was reintroduced today & needs support. The House bill has a majority of cosponsors & we need to show the same support for #S3081 to enact this common sense legislation. Had enough of PA? Take action ?

Megan Tweed, Director of Government Affairs, American Gastroenterological Association: Attention #specialtydocs! This is NOT a drill! Police cars revolving light The Senate #priorauth bill was officially reintroduced today! We know the burden PA has on you and your patients. Urge your Senators to cosponsor #S3018 and #fixpriorauth: https://gastro.quorum.us/campaign/33270/ #AGAAdvocacy @AmerGastroAssn

Blair Childs, Senior Vice President of Public Affairs, Premier Inc.: The Improving Seniors’ Timely Access to Care Act is a giant step forward in bringing Medicare Advantage plans’ prior authorization into the 21st Century. TY @RogerMarshallMD @SenatorSinema @SenJohnThune for advancing a bill to end related care delays, harm & costs. #Fixpriorauth

Michigan Society of Hematology and Oncology: Thank you to @RogerMarshallMD @SenatorSinema @SenJohnThune for introducing the Improving Seniors’ Timely Access to Care Act which would simplify and streamline the #priorauth processes in Medicare Advantage…

Joseph Marine, M.D., Chair of the Board of Governors, American College of Cardiology: Great news on #Fixpriorauth. Thank you @RogerMarshallMD, @SenatorSinema and @SenJohnThune! @Cardiology @ACCMaryland @arwaxler Companion Legislation Introduced in Senate to Address ACC-Supported Prior Authorization Reform – American College of Cardiology

Dennis Calnon, M.D., President-Elect, American Society of Nuclear Cardiology: #PriorAuth = physician burnout and less time with patients. Time for Congress to #FixPriorAuth and pass the “Improving Seniors’ Timely Access to Care Act.” @MyASNC applauds @RogerMarshallMD @SenatorSinema @SenJohnThune for reintroduction of the legislation in the Senate. #CVNuc

Sam Jones, M.D., Chair of Health Affairs, American College Cardiology: Great news!  Companion Legislation Introduced in Senate to Address ACC-Supported Prior Authorization Reform – American College of Cardiology #fixpriorauth @Cardiology @RogerMarshallMD @SenatorSinema@SenJohnThune

Benjamin Galper, M.D., Mid-Atlantic Permanente Medical Group Structural Heart Disease Program Director: Great to see @Cardiology advocacy at work! Excited to see bipartisan support to address prior authorization and ensure no one can block patients from getting the care they need. Thank you @RogerMarshallMD, @SenatorSinema and @SenJohnThune #Fixpriorauth

Alison Baily, M.D., Editorial Board Editor-in-Chief, American College of Cardiology: @RogerMarshallMD @SenatorSinema @SenJohnThune are working to #fixpriorauth and put patients over paper!  https://bit.ly/3E2h2F0 @Cardiology @ACCinTouch @apmille1 @sandylewis @SamOJonesMD @TNChapterACC

Marion Mass, M.D., Co-founder, Practicing Physicians of America: Thank you, @RogerMarshallMD @SenatorSinema @SenJohnThune @RepDelBene @MikeKellyPA @RepBera @RepLarryBucshon for reforming #priorauth with the Improving Seniors’ Timely Access to Care Act. time to #cuttheglut of regulation!

Background:

Prior authorization is a tool used by health plans to reduce spending from improper payments and unnecessary care by requiring physicians and other health care providers to get pre-approval for medical services. But it’s not without fault. The current system of unconfirmed faxes of a patient’s medical information or phone calls by clinicians takes precious time away from delivering quality and timely care. Prior authorization continues to be the #1 administrative burden identified by health care providers and nearly four out of five Medicare Advantage enrollees are subject to unnecessary delays. In recent years, the Office of the Inspector General at the U.S. Department of Health and Human Services raised concerns after an audit revealed that Medicare Advantage plans ultimately approved 75% of requests that were originally denied.

Health plans, health care providers, and patients agree that the prior authorization process must be improved to better serve patients and reduce unnecessary administrative burdens for clinicians. In fact, leading health care organizations released a consensus statement to address some of the most pressing concerns associated with prior authorization. Building on these principles, the bipartisan legislation would:

• establish an electronic prior authorization process that would streamline approvals and denials;
• establish national standards for clinical documents that would reduce administrative burdens health care providers and Medicare Advantage plans;
• create a process for real-time decisions for certain items and services that are routinely approved;
• increase transparency that would improve communication channels and utilization between Medicare Advantage plans, health care providers, and patients;
• ensure appropriate care by encouraging Medicare Advantage plans to adopt policies that adhere to evidence-based guidelines; and
• require beneficiary protections that would ensure the electronic prior authorization serves seniors first. 

The House companion – led by Representatives Suzan DelBene (D-WA), Mike Kelly (R-PA), Ami Bera, M.D. (D-CA), and Larry Bucshon, M.D. (R-IN) – was reintroduced in May.

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