Now is an ideal time to urge senators and representatives to enact The Improving Seniors’ Timely Access to Care Act (HR 3514/S 1816), legislation that would modernize and streamline PA in MA and increase plans’ transparency and accountability in their use of PA in making coverage decisions. Today, each MA organization has its own PA request process and internal criteria for coverage decisions, which adds to providers’ costs, creates uncertainty for residents/patients, and forces staff to devote time obtaining approvals or overturning appeals–time that would otherwise be spent with residents and patients.

For aging services providers and the older adults they serve, delays in PA decisions can mean delays in accessing needed care and services, while complex and inconsistent processes create substantial administrative work for providers.

The legislation would help address these challenges by standardizing and modernizing the PA process, supporting electronic PA, expediting decisions, and requiring greater transparency into plan practices and outcomes.

This legislation has been refined over multiple congresses with input from lawmakers, the Centers for Medicare and Medicaid Services (CMS), health care providers, plans, patients, and other stakeholders. With broad bipartisan support, in July it  advanced unanimously through both the House Ways and Means and Energy and Commerce Committees.

We cannot let the 119th Congress come to a close without getting these important reforms across the finish line.

Urge your members of Congress to pass the Improving Seniors’ Timely Access to Care Act and to ask leadership in both chambers to bring the legislation up for a vote before the end of the year.

Please consider personalizing your email message by briefly describing how PA delays or administrative requirements and the lack of PA standardization affect your organization, staff, residents, patients, or the older adults you serve.