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Contact Your Representative Now! |
Prior authorization (PA) is a process where physicians and other medical care providers must obtain pre-approval for certain procedures and treatments from health insurance companies before rendering care to their patients. In recent years, this process has become increasingly dangerous for patients and burdensome for providers.
Insurance companies have repeatedly expanded the scope of services that require prior authorization, often delaying or denying care even when it is medically necessary.
The Process
Patients Can Experience Delays of up to 3 Weeks Before Receiving PA Approval
What Is the Impact on Providers and Patients?
How Can Congress Fix Prior Authorization?
The prior authorization process was intended to control costs, but in practice, it has become a significant barrier to timely and necessary medical care. Physicians regularly encounter administrative obstacles that delay treatment, leading to worse patient outcomes, unnecessary hospitalizations, and frustration for both patients and providers.
The Improving Seniors' Timely Access to Care Act (H.R. 3514/S. 1816) by Rep. Mike Kelly (R-PA) and Rep. Suzan DelBene (D-WA) and Senators Roger Marshall, MD (R-KS) and Mark Warner (D-VA) would ensure that prior authorization decisions in Medicare Advantage are made by board-certified physicians, not by insurance administrators or automated systems. The bill would also establish clear guidelines that prior authorization decisions must be based on medical necessity, not cost-cutting measures.
Physicians should be able to make medical decisions based on their expertise without unnecessary interference from insurers. Congress must act now to reform prior authorization and return medical decision-making to the professionals who know their patients best.
Tell your representatives to support the Improving Seniors' Timely Access to Care Act and ensure that physicians—not insurers—determine the care patients receive.