WASHINGTON, D.C. — The House Ways & Means Health Subcommittee approved the Improving Seniors' Timely Access to Care Act. The measure mandates increased transparency and accountability from Medicare Advantage plans concerning prior authorization decisions.

The bill requires Medicare Advantage plans to provide information on prior authorization denials. It directs the Centers for Medicare & Medicaid Services to publish each plan's denial track record on a public-facing website. The legislation stipulates that the Medicare Payment Advisory Commission and the Government Accountability Office must issue reports on how plans manage prior authorization. Additionally, the bill mandates the systemic use of electronic prior authorization for Medicare Advantage.

U.S. Representative Suzan DelBene commented on the bill's progress. "We've never been in a better position to finally get this important piece of legislation over the finish line," DelBene said. She stated, "Delivering the care seniors need when they need it by reforming prior authorization in Medicare Advantage has broad bipartisan consensus in Congress." DelBene added, "The bill recently reached the critical 290 cosponsor threshold again." She said, "That's why I'm pushing for a quick vote in the House to get this legislation over the finish line before the end of this Congress." The version of the bill introduced in May 2025 by Representative Mike Kelly has 296 House cosponsors, including 167 Democrats and 129 Republicans. A companion bill in the Senate, introduced by Senator Roger Marshall, has 70 cosponsors, including 37 Democrats, 32 Republicans, and one independent.

The American Medical Association issued a statement commending the subcommittee for advancing the legislation. John Whyte, CEO of the association, stated, "This bipartisan legislation would eliminate unnecessary administrative red tape in Medicare Advantage to ensure that critical, lifesaving care is no longer delayed by an overused prior authorization process." John Knapp, vice president for advocacy at Premier, commented, "Codifying and enhancing regulations that accelerate the move to electronic prior authorization will help ensure more timely, efficient care for seniors while improving quality and reducing administrative strain." A survey by Premier of 516 hospitals across 36 states found that prior authorization delays in Medicare Advantage cost providers an estimated $19.7 billion annually to manage.

The bill must receive approval from the full Ways & Means Committee and the House Energy & Commerce Committee before it can be voted on by the House. The legislation was first introduced in 2019 but did not advance. It was reintroduced in 2021, passed the House, but was not taken up by the Senate. The Congressional Budget Office estimated the 2021 version would cost $16.2 billion over 10 years. Sponsors reintroduced the bill in June 2024 after modifications aimed at reducing the estimated cost to zero, but this version did not pass. In January 2024, the Biden administration finalized a regulation that included similar provisions, requiring Medicare Advantage plans to issue prior authorization decisions within 72 hours for urgent requests and within 7 calendar days for non-urgent requests. This regulation became effective in 2025.