Congressional Physicians Introduce Medicare Advantage Improvement Act to Expedite Prior Authorization
Representative John Joyce has introduced the Medicare Advantage Improvement Act in the House, co-sponsored by several physician members of Congress, including Representatives Kim Schrier, Greg Murphy, Mariannette Miller-Meeks, and Ami Bera. The bipartisan legislation aims to address excessive use of prior authorization and inappropriate coverage denials within Medicare Advantage plans. The bill proposes a mandatory 72-hour deadline for health plans to process standard prior authorizations, with extensions of up to seven days allowed only in limited circumstances. Additionally, the legislation mandates the use of automated approval systems integrated into electronic health records for real-time updates and prohibits new authorizations for clinically necessary modifications or extensions during treatment. The bill also calls for increased transparency, requiring insurers to publish data on prior authorizations, including determination times. This initiative follows a Department of Health and Human Services i... 
