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Prior Authorization Legislation Reaches Important Milestone

Legislation to streamline prior authorization has reached an important milestone, with a bipartisan majority in the U.S. House of Representatives now cosponsoring the bill. Introduced last year by Reps. Suzan DelBene (D-Wash.), Mike Kelly (R-Pa.), Roger Marshall, MD, (R-Kan.) and Ami Bera, MD, (D-Calif.), H.R. 3107, the Improving Seniors’ Timely Access to Care Act, would protect patients in Medicare Advantage from unnecessary prior authorization practices that limit timely access to medically necessary care.

The AANS and the CNS are leading the Regulatory Relief Coalition’s (RRC) effort to improve prior authorization. In a statement released on June 11, 2020, Ann R. Stroink, MD, FAANS, chair of the AANS/CNS Washington Committee, noted that “It is especially critical coming out of the COVID-19 crisis, that patients not face additional obstacles to getting the care they need. My patients have faced delays in their surgery for several months, so relieving prior authorization burdens will help.” The bill’s sponsors also featured Dr. Stroink in their release, where she stated:

Neurosurgeons take care of very sick patients who suffer from painful and life-threatening neurologic conditions such as brain tumors, debilitating, degenerative spine disorders and stroke, and without timely medical care, our patients often face permanent neurologic damage, and sometimes death. Streamlining prior authorization will help ensure that our seniors get the care they need without delay, and we are thrilled that a bipartisan majority of the House of Representatives now supports H.R. 3107.

Companion legislation is expected to be introduced in the U.S. Senate in July.