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Morning Briefing

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Thursday, Sep 15 2022

Full Issue

House Passes Medicare Advantage Reform Bill; It Now Heads To Senate

The Improving Seniors’ Timely Access to Care Act strives to make it easier for seniors to get care and to modernize the process of prior authorizations. For example, the current process often still requires using fax machines to send documents to insurance companies.

Medicare Advantage carriers would be subject to new requirements governing the prior authorization process under legislation that passed the House Wednesday. The measure would compel Medicare Advantage insurers to use electronic prior authorization programs, annually submit lists of items and services subject to prior authorization, and adopt beneficiary protection standards. The Improving Seniors’ Timely Access to Care Act now moves the Senate, where supporters hope it will advance after the November congressional elections. (Goldman, 9/14)

The legislation was led in the House by Representatives Suzan DelBene, D-Washington, Mike Kelly R-Pennsylvania, Ami Bera, MD, D-California, and Larry Bucshon, MD R-Indiana. “Seniors and their families should be focused on getting the care they need, not faxing forms multiple times for procedures that are routinely approved. This takes away valuable time from providers who on average spend 13 hours a week on administrative paperwork related to prior authorization,” the representatives said in a joint statement published Sept. 14. “The Improving Seniors’ Timely Access to Care Act will make it easier for seniors to get the care they need by cutting unnecessary red tape in the health care system. We urge the Senate to quickly take up this legislation and get it to President Biden’s desk.” (Payerchin, 9/14)

In other Medicare and Medicaid news —

Medicare is vastly underserving older Americans with opioid use disorder, with only 18% of enrollees with the diagnosis receiving recommended medication treatment, according to a new federal oversight report. (Joseph, 9/15)

Florida is trying to fend off a potential class-action lawsuit alleging that the Medicaid program is denying coverage for incontinence supplies in violation of laws such as the Americans with Disabilities Act. (Saunders, 9/14)

The director of the state agency overseeing Medicaid says an application backlog that caught the federal government’s attention has been eliminated. (Suntrup, 9/14)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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