Communications

(May 23, 2025) – This week, the Kansas Hospital Association applauded U.S. Senator Roger Marshall, MD (R-Kansas) for reintroducing the Improving Seniors' Timely Access to Care Act. This bipartisan legislation, at zero cost to taxpayers, takes long-overdue steps to modernize the broken prior authorization process in Medicare Advantage.

Nearly three out of four Medicare Advantage enrollees are subject to unnecessary delays because of prior authorization, resulting in multiple faxes or phone calls from hospitals and clinicians, which takes precious time away from delivering care. For Kansas hospitals, especially those already strained by workforce shortages and tight margins, these barriers have forced the hiring of additional administrative staff just to manage prior authorization-related paperwork.

This legislation would significantly reduce these burdens by establishing a standardized electronic prior authorization process, ensuring timely approvals and improving transparency. Most importantly, it enables hospitals and clinicians to focus their time and resources on patient care. In a press release this week, KHA shared this:

"We've long supported common-sense reforms to prior authorization, and this bill is a strong step in the right direction," said Chad Austin, KHA president and CEO. "Hospitals across Kansas have been forced to devote significant resources to deal with unnecessary delays and denials—resources that should be focused on patients. We're grateful to Senator Marshall for championing this effort to protect seniors' access to timely, high-quality care while easing avoidable burdens on hospitals and providers."

The bill will help hospitals and physicians better serve and improve care for the more than 196,000 Kansans enrolled in a Medicare Advantage plan. By reducing unnecessary wait times and denials, this legislation will help ensure patients receive care when needed, not after delays that can worsen outcomes.

The bill's strong bipartisan support, with more than 45 cosponsors in the Senate, underscores the broad agreement that the current prior authorization system needs reform. KHA encourages Congress to swiftly pass this legislation and provide meaningful relief for providers and patients.

The Improving Seniors' Timely Access to Care Act would:

• Establish an electronic prior authorization process for Medicare Advantage plans, including standardizing transactions and clinical attachments.
• Increase transparency around Medicare Advantage prior authorization requirements and their use.
• Clarify HHS's authority to establish timeframes for e-prior authorization requests, including expedited determinations, real-time decisions for routinely approved items and services, and other prior authorization requests.
• Expand beneficiary protections to improve enrollee experiences and outcomes.
• Require the U.S. Department of Health and Human Services, and other agencies, to report to Congress on program integrity efforts and other ways to improve the e-prior authorization process further.
• Result in zero cost to American taxpayers.

The full text of the legislation can be found here.
--Jaron Caffrey