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Prior authorization bill nears milestone in the House

The Improving Seniors' Timely Access to Care Act (S 1816/HR 3514) is just a few co-sponsors away from hitting two-thirds support in the House of Representatives.

  • 290 co-sponsors is a symbolic "magic number" as it’s a threshold for overriding a presidential veto and passing certain other appropriations.
  • As of today, HR 3514 has 283 co-sponsors after Reps. Sheri Biggs (R-SC) and Brian Babin (R-TX) signed on to the bill last Wednesday.

The CAP has supported the bill’s passage since it was introduced almost a year ago.

  • We've asked pathologists to use our Action Center to encourage lawmakers to pass the bill. 

Background: The zero-cost bill would simplify the prior authorization process in Medicare Advantage and improve access to care for more than 32.8 million seniors.

The impact: Streamlined prior authorization would allow physicians to spend more time on patient care and less on administrative red tape.

Key provisions: The bill would codify and strengthen CMS’ 2024 electronic prior authorization rule.

  • It pushes Medicare Advantage plans toward faster electronic processes rather than manual approvals.
  • It aims to standardize, automate, and make prior authorization more transparent, reducing inappropriate denials.

The bill has earned strong bipartisan backing in past Congresses, including unanimous House passage in 2022.

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