Prior Authorization Legislation Introduced in the House
On June 9, Reps. Michael Burgess, MD, (R-Texas) and Vicente Gonzalez (D-Texas) introduced the Getting Over Lengthy Delays in Care As Required by Doctors Act (GOLD CARD) Act ( H.R. 7995), a bipartisan bill that the AANS and the CNS helped draft. This bill would exempt certain physicians from prior authorization in the Medicare Advantage (MA) program. Specifically, the legislation would exempt providers from prior authorization requirements for one year if the provider had at least 90% of prior authorization requests approved the preceding year.
In announcing the introduction of the legislation, Reps. Burgess and Gonzalez issued a press release featuring John K. Ratliff, MD, FAANS, who stated:
Since most medical services are ultimately approved, the GOLD CARD Act is a commonsense approach to addressing the unnecessary burdens caused by the widespread use of prior authorization. Neurosurgical patients suffer from painful and life-threatening neurologic conditions such as brain tumors, debilitating degenerative spine disorders, stroke and Parkinson’s Disease, and without timely care, they often face permanent neurologic damage and sometimes death. If adopted, Rep. Burgess’ and Gonzalez’s legislation would be a significant step in making sure our seniors get the care they need when they need it, and America’s neurosurgeons are proud to endorse this bill.