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Faster Access to Care: Streamlining Prior Authorization in Medicare Advantage

This law establishes new rules for Medicare Advantage plans to standardize and speed up the process of obtaining prior authorization for medical services. Citizens will benefit from faster treatment decisions through a mandatory electronic system and greater transparency regarding the criteria used by insurance plans to approve or deny requests.
Key points
Mandatory implementation of an electronic prior authorization (e-PA) system starting in 2027, intended to reduce waiting times for treatment approval.
Medicare Advantage plans must publish data on how many authorization requests they deny, how many are appealed, and the time taken to make a decision.
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Additional Information
Improving Seniors’ Timely Access to Care Act of 2024
Print number: S 4532
Sponsor: Sen. Marshall, Roger [R-KS]
Process start date: 2024-06-13