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May 21, 2025 - Contact: Charlotte Pineda
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cpineda@neurosurgery.org
Neurosurgeons Applaud Reintroduction of Legislation to Improve Prior Authorization for Seniors
Washington, DC— Today, the American Association of Neurological Surgeons (AANS) and the Congress of
Neurological Surgeons (CNS), leading members of the Regulatory Relief Coalition (RRC), applauded the
bipartisan reintroduction of the Improving Seniors’ Timely Access to Care Act (S 1816/ HR 3514). This critical
legislation would streamline and modernize the prior authorization process in Medicare Advantage (MA) plans,
while also adding meaningful program integrity provisions to ensure the MA functions as intended.
Introduced by U.S. Senators Roger Marshall, MD (R-KS), and Mark Warner (D-VA), along with Representatives
Mike Kelly (R-PA), Suzan DelBene (D-WA), Ami Bera, MD (D-CA), and John Joyce, MD (R-PA), the bill
garnered a total of 48 Senators and 74 Representatives as original cosponsors upon reintroduction.
“Strengthening oversight of prior authorization in Medicare Advantage ensures the program delivers on its promise
of timely care for America’s seniors,” said Alexander A. Khalessi, MD, MBA, Chair of the AANS/CNS
Washington Committee. “Today, patients with urgent neurologic conditions face delays and denials that risk
permanent disability or worse. We thank the House and Senate champions for their continued bipartisan leadership
to ensure that medical urgency, not administrative process, guides access to care. Congress has the opportunity to
deliver a meaningful victory for seniors by swiftly sending this legislation to the president’s desk. Let’s allow
surgeons to focus on their patients.”
The bill represents the culmination of a multi-year, evidence-based effort led by physicians, patients, and other
health care stakeholders. It has already shaped recent federal policy, with CMS proposing or finalizing several rules
that were modeled in large part on the legislation. These regulatory actions significantly reduced the bill’s projected
cost. Although it previously passed the House unanimously and earned broad bipartisan support in both chambers,
earlier budget concerns stalled its progress. Following targeted refinements, the updated bill received a zero-cost
score from the Congressional Budget Office in October 2024, clearing the path for final passage.
Specifically, the legislation would:
- Establish an electronic prior authorization process for MA plans, including standardized transactions and clinical
attachments. - Increase transparency around MA prior authorization requirements and utilization.
- Enable real-time decisions for routinely approved items and services, and clarify CMS’ authority to establish
response timeframes for all e-PA requests. - Expand beneficiary protections to improve enrollee experiences and outcomes.
- Require federal agencies to report to Congress on program integrity efforts and ways to improve the e-PA
process.
The RRC has served as a principal architect and champion of these reforms, advocating on behalf of the more than 34
million seniors enrolled in Medicare Advantage plans and the members who care for them.
In the previous Congress, more than 500 national and state organizations – including those representing patients,
providers, Medicare Advantage plans, and the medical device, pharmaceutical, and health IT industries – endorsed the
legislation. That momentum continues, with over 140 organizations already reaffirming their support this Congress.
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The American Association of Neurological Surgeons (AANS), founded in 1931, and the Congress of Neurological Surgeons (CNS),
founded in 1951, are the two largest scientific and educational associations for neurosurgical professionals in the world. These groups
represent over 10,000 neurosurgeons worldwide. Neurological surgery is the medical specialty concerned with the prevention, diagnosis,
treatment and rehabilitation of disorders that affect the entire nervous system, including the spinal column, spinal cord, brain and peripheral
nerves. For more information, please visit www.aans.org, www.cns.org and www.neurosurgery.org
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