Faster Healthcare Access for Seniors: Streamlining Medicare Advantage Prior Authorization.
This law aims to speed up and simplify the process of obtaining approval (prior authorization) for medical services under Medicare Advantage plans. It mandates the use of electronic authorization systems and increases transparency by requiring plans to publish data on wait times and denial rates. This means seniors should receive quicker decisions regarding necessary medical care, improving the timeliness of their treatment.
Key points
Starting 2027, Medicare Advantage plans must use a secure, electronic system for treatment approval, moving away from faxes and non-standard portals.
Starting 2026, plans must publicly disclose detailed data on which services require authorization, how long decisions take, and how many requests are denied, increasing plan transparency.
The Secretary gains authority to set short deadlines (e.g., 24 hours) for plans to respond to prior authorization requests, especially for urgent or routinely approved services.
Expired
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