500+ advocacy groups endorse legislation to improve health care access

FILE - Health care
FILE - Health care(MGN)
Published: Jul. 19, 2022 at 9:47 AM CDT
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TOPEKA, Kan. (WIBW) - More than 500 advocacy groups have endorsed legislation led by Senator Roger Marshall to improve health care access for seniors.

In October 2021, U.S. Senator Roger Marshall (R-Kan.) says he and Sens. Kyrsten Sinema (D-Ariz.), John Thune (R-S.D.) and Sherrod Brown (D-Ohio) introduced the Improving Seniors’ Timely Access to Care Act, which now has more than 500 signatures from advocacy groups.

“The massive support for this legislation from Republicans and Democrats in both chambers of Congress, along with the more than 500 groups that have endorsed it, is proof that this is truly a good faith effort to make health care better for America’s seniors,” Marshall said. “There’s a reason why the Improving Seniors’ Timely Access to Care Act is one of the most popular bills this Congress. Modernizing Medicare Advantage is the number one administrative hurdle for physicians and I can personally speak to these challenges as a physician myself and from my time managing Great Bend Regional Hospital. I’m grateful for all the hard work that has gone into creating significant momentum for this bill.”

Marshall said the bipartisan legislation would improve timely access to quality care for seniors on Medicare Advantage. Specifically, he said the bill would modernize the way Medicare Advantage plans and health care providers use prior authorization.

Since it was introduced, Marshall noted that more than 500 organizations that represent patients, physicians, hospitals and other key stakeholders in the healthcare industry have officially endorsed the bill.

“We’re proud our bipartisan bill modernizing and improving Arizona seniors’ access to timely health care has earned 500 endorsements – we’ll continue working to get our bipartisan legislation across the finish line,” Sinema said.

Marshall noted that prior authorization is a tool for health plans to reduce spending from improper payments and unnecessary care with the requirement of all physicians and health care providers to get pre-approval for medical services. However, he said it is not without fault.

The Senator indicated the current system of unconfirmed faxes of a patient’s medical information or phone calls by clinicians takes time away from the delivery of quality care. He said prior authorization continues to be the No. 1 administrative burden for health care providers and nearly four out of five Medicare Advantage enrollees are subject to unnecessary delays.

In recent years, Marshall also said the Office of the Inspector General at the U.S. Department of Health and Human Services which raised concerns after an audit found the plans ultimately approved 75% of requests that had originally been denied.

Marshall said health plans, health care providers, and patients agree that prior authorization needs to be improved to better serve patients and reduce burdens for clinicians. In fact, he said leading healthcare organizations released a consensus statement to address some of the most concerns. He noted the legislation would:

  • Establish an electronic prior authorization process that would streamline approvals and denials;
  • Establish national standards for clinical documents that would reduce administrative burdens health care providers and Medicare Advantage plans;
  • Create a process for real-time decisions for certain items and services that are routinely approved;
  • Increase transparency that would improve communication channels and utilization between Medicare Advantage plans, health care providers, and patients;
  • Ensure appropriate care by encouraging Medicare Advantage plans to adopt policies that adhere to evidence-based guidelines; and
  • Require beneficiary protections that would ensure the electronic prior authorization serves seniors first.

For a full list of organizations that have announced support for the legislation, click HERE.

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