Newswise — Washington, DC—Today, the American Association of Neurological Surgeons (AANS) and Congress of Neurological Surgeons (CNS) applauded the introduction of the Improving Seniors’ Timely Access to Care Act, which would streamline prior authorization in the Medicare Advantage program.
With 42 original co-sponsors in the U.S. Senate and 130 in the U.S. House of Representatives, this legislative effort is led by Sens. Roger Marshall, MD (R-Kan.); Kyrsten Sinema (I-Ariz.); John Thune (R-S.D.) and Sherrod Brown (D-Ohio) and Reps. Mike Kelly (R-Pa.), Suzan DelBene (D-Wash.), Ami Bera, MD, (D-Calif.) and Larry Bucshon, MD, (R-Ind.). This bipartisan bill would codify and enhance elements of the Advancing Interoperability and Improving Prior Authorization Processes rule that was finalized by the Centers for Medicare & Medicaid Services (CMS) earlier this year. The bill would:
- Establish an electronic prior authorization (e-PA) process for MA plans;
- Increase transparency around MA prior authorization requirements and their use;
- Provide a pathway for CMS to institute real-time decisions for routinely approved medical services;
- Clarify CMS’ authority to establish timeframes for e-PA requests; and
- Require several reports to Congress on program integrity efforts and other ways to improve the e-PA process.
To help ensure swift passage in Congress, the bill sponsors made modest changes to the legislation to align with CMS’ final rule and to reduce the Congressional Budget Office score. Changes include removing the requirement for CMS to implement real-time prior decisions and adjusting the timeframes for plans to make PA determinations.
“This is a pivotal moment for enhancing patients’ access to care,” said Russell R. Lonser, MD, FAANS, chair of the department of neurosurgery at The Ohio State University and chair of the American Association of Neurological Surgeons and Congress of Neurological Surgeons Washington Committee. He added, “The widespread overuse of prior authorization, especially in Medicare Advantage, has led to unacceptable delays and denials of essential medical treatments. We are optimistic that this will be the year Congress acts to safeguard timely care for our seniors.”
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The American Association of Neurological Surgeons (AANS), founded in 1931, and the Congress of Neurological Surgeons (CNS), founded in 1951, are the two largest scientific and educational associations for neurosurgical professionals in the world. These groups represent over 10,000 neurosurgeons worldwide. Neurological surgery is the medical specialty concerned with the prevention, diagnosis, treatment and rehabilitation of disorders that affect the entire nervous system, including the spinal column, spinal cord, brain and peripheral nerves. For more information, please visit www.aans.org, www.cns.org and www.neurosurgery.org.
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