House Markup of Prior Authorization Relief Bill a Good Step in Protecting Seniors’ Timely Access to Care
The Community Oncology Alliance (COA) applauds the House Ways and Means Committee for passing the Improving Seniors’ Timely Access to Care Act of 2022 (H.R. 8487), reintroduced this session by Reps. Suzan DelBene (D-WA), Mike Kelly (R-PA), Ami Bera, MD, (D-CA), and Larry Bucshon, MD, (R-IN).
The Improving Seniors’ Timely Access to Care Act is an important piece of legislation that protects seniors from delays in treatment by creating a streamlined, efficient prior authorization system for the Medicare Advantage (MA) program.
The act establishes an electronic prior authorization program for MA plans and requires that these requests be reviewed by qualified medical personnel, not bureaucrats. The bill also establishes a list of transparency standards to decrease prior authorization denials and protects MA plan beneficiaries from disruptions in care due to prior authorizations. In April, the Office of Inspector General found that 13% of prior authorization denials fit within Medicare coverage requirements, as did 18% of denied payment requests. The report echoes COA’s position on prior authorizations and lays bare an unflattering truth: the current prior authorization system is hurting America’s seniors.
“Delays in cancer care can be life-threatening,” said Kashyap Patel, MD, president of COA. “This bill reduces the likelihood that bureaucratic snafus will interfere with treatment and makes it easier for practices to know why a denial was issued so they can avoid the same mistake in the future. I am glad to see that Reps. DelBene, Kelly, Bera, and Bucshon have reintroduced the bill.”
COA Medical Director of Public Policy Mark Thompson, MD, emphasized the need for a better prior authorization system due to the challenges of cancer care.
“When a senior is receiving cancer treatment, time is of the essence. We can’t wait weeks or months for approval to start treatment. This bill removes a lot of uncertainty for seniors who are seeking medical care, and that is so valuable for effective treatment and the patient’s peace of mind,” he said.
COA looks forward to supporting the Improving Seniors’ Timely Access to Care Act and speaking with other legislators about the importance of protecting access to health care, especially for the nation’s senior population. This bill is a significant first step towards fixing the broken prior authorization system that doctors know all too well and that patients with cancer face every day.
About the Community Oncology Alliance: COA is a non-profit organization dedicated to advocating for community oncology practices and, most importantly, the patients they serve. COA is the only organization dedicated solely to community oncology where the majority of Americans with cancer are treated. The mission of COA is to ensure that patients with cancer receive quality, affordable, and accessible cancer care in their own communities. More than 5,000 people in the United States are diagnosed with cancer every day and deaths from the disease have been steadily declining due to earlier detection, diagnosis, and treatment. Learn more at www.CommunityOncology.org. Follow COA on Twitter at www.twitter.com/oncologyCOA or on Facebook at www.facebook.com/CommunityOncologyAlliance.