With the prior authorization rule recently finalized by the Centers for Medicare and Medicaid Services (CMS) , Congress needs to step in and make additional meaningful reforms.  

As physicians know all too well, many patients in Medicare Advantage plans are subject to delays in treatment because of restrictive prior authorization requirements. Patients who are in group health insurance plans are forced to fail first on the plans’ prescription drugs before the clinically recommended drug can be dispensed. To address these critical issues, we need your help in urging your members of Congress to include two pieces of legislation, the Improving Seniors Timely Access to Care Act and the Safe Step Act, in any legislative package addressing access to care and health care costs, or passing them as standalone legislation. 

Background: 

The Improving Seniors Timely Access to Care Act has been an ACP priority for several years but has not yet been reintroduced this year. It would streamline prior authorization processes for Medicare Advantage plans, going beyond the recently finalized CMS rule in addition to codifying into law the reforms in the rule. The Safe Step Act, H.R. 2630/S. 652, is one of the bills that ACP members advocated during last year’s Leadership Day and would require group health plans to provide an exception process for any medication step therapy protocol to help ensure that patients can safely and efficiently access treatment. 

Action Requested: Please email your members of Congress asking them to support these important priorities. A sample message to members of Congress is provided for you that contains blank fields for you to personalize. 

Thank you for your continued advocacy.

Please contact Shuan Tomlinson at stomlinson@acponline.org with any questions about this campaign.