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CMS Finalizes Electronic Prior Authorization Rule to Reduce Barrier to Care and Lessen Physician Burden Associated with Payers’ Prior Authorization Requirements

House and Senate champions issued the following statement on the rule finalization
“Today’s action by CMS is a major win for seniors and their families. These new regulations will make a big difference in helping seniors access the medical care they are entitled to without unnecessary delays and denials due to prior authorization. The regulations will also enable health care providers to focus on delivering better care rather than wasting hours on the phone with insurance companies. While these regulations could have gone further, they will help bring the antiquated prior authorization system into the 21st century with commonsense changes like a streamlined approval process and increased transparency.

Now, Congress must act to cement these gains into law by passing the overwhelmingly bipartisan, bicameral Improving Seniors’ Timely Access to Care Act to ensure seniors are getting the care they’re entitled to and reduce hours of unnecessary burden for physical practices and hospitals.”


See RRC Press Release
See Final Rule

See CMS Fact Sheet
See RRC’s Comments on the proposed rule

MA 2025 Proposed Rule

See RRC’s comments on the 2025 MA proposed rule released by CMS.

Improving Seniors’ Timely Access to Care included in House Energy & Commerce Hearing

See Letter to Energy and Commerce Committee Subcommittee on Health
See Energy and Commerce Hearing Announcement and Memo

Improving Seniors’ Timely Access to Care included in House Ways and Means Committee Passage of Health Care Transparency Act of 2023 (H.R.4822)

On July 26, 2023, the House Committee on Ways and Means passed out of committee legislation that incorporates the Improving Seniors’ Timely Access to Care Act, with minor technical corrections.  RRC applauds the Ways and Means Committee, especially Reps. Mike Kelly (R-PA), and Suzan DelBene (D-WA) for advancing this legislation to ensure that Medicare Advantage (MA) policies are not a barrier to timely and equitable access to care for the patients our members serve.

See RRC Press Release

See RRC Letter to Ways and Means Committee.

See House Champions Statement on Passage

See Ways and Means Markup

Congressional Letters Achieve Majority in Both House and Senate

Groundswell of Congressional Support to Reign in Prior Authorization in Medicare Advantage evidenced in House and Senate sign on letters.  Letters ask CMS to finalize pending rules that would reign in the overreaches of MA plans that delay and deny care through utilization management tools like PA.


See Press/Social Media

See House Letter

See Senate Letter

Removing regulatory barriers to timely access to care

Your Story Makes a Difference

Share your prior authorization stories with us here.

RRC Thanks Chair Blumenthal and Ranking Member Johnson of the Senate Committee on Homeland Security and Government Affairs Permanent Subcommittee on Investigations for Holding Hearing on Medicare Advantage.

Read the letter here.

RRC strongly supports CMS proposed rule to reduce barriers to care and lessen physician burden associated with payers’ prior authorization requirements. Coalition urges CMS to finalize this proposed rule as soon as possible.

RRC applauds requirements for electronic prior authorization systems and payer transparency.

Read the letter here.

RRC applauds CMS for proposed rule to reign in prior authorization in Medicare Advantage program. Coalition has offered recommendations to strengthen rule.

RRC Concurs with CMS: Prior Authorization Should Not Be Used to Delay or Deny Care

Read RRC’s comments here.
Read RRC’s press release here.

RRC lauds proposed rule mirroring House-passed bill to streamline prior authorization in Medicare Advantage program.

Coalition concurs with CMS that changes are “overdue, feasible, and would benefit patients and providers.”

Read RRC’s press release here.

The lead sponsors of The Improving Seniors’ Timely Access to Care Act (H.R. 3173) sent a letter to House and Senate Leadership urging them to advance the bill in any year-end legislative package.

American Society of Clinical Oncology (ASCO) survey shows negative impact of prior authorization on cancer care. Nearly all oncology providers report prior authorization causing delayed care and other patient harms.

The lead sponsors of The Improving Seniors’ Timely Access to Care Act (H.R. 3173) sent letters to House Leadership and the Administration about the importance of this prior authorization legislation.

Improving Seniors’ Timely Access to Care Act is Scheduled for a House Vote on September 14th

Read RRC’s Letter to House Leadership here.

Read RRC’s Letter to Energy & Commerce Health Subcommittee here.

Ways and Means Advances Improving Seniors’ Timely Access to Care Act

Read RRC’s letter of support to Ways and Means here.

Read RRC’s press release here.

Read AANS-CNS’ press release here.

RRC Sends Letter to E&C Oversight

Read the letter here.

Better Medicare Alliance Endorses Improving Seniors’ Timely Access to Care Act

Read what the organization, that includes major health plans, has to say.

New GAO Study Finds Prior Authorization Less Likely to be Granted for Mental Health

Read the GAO study.

Read analysis of the study.

Mental Health Groups Endorse Bipartisan Prior Authorization Legislation

Congressional champions call for legislation to be included in mental health package.

Read what Rep. DelBene has to say.

Read the MHLG Letter.

RRC hosts briefing with Senators and staff on The Improving Seniors’ Access to Timely Care Act (S.3018/H.R. 3173)

We were thrilled to be joined by Senators Marshall and Sinema live, as well as Senator Thune by video. We were also joined by staff participants Charlotte Pineda (Marshall), Abby Duggan (Brown), Danielle Janowski (Thune),  Kevin Dawson (Cassidy), Sylvia Lee (Sinema), and Anthony Theissen (Carper).   

Watch the briefing and view the slides.

Coalition Applauds Senate for Introduction of Prior Auth. Reform Legislation: Coalition Calls for Congressional Action in 2021

Review the Senate bill (S. 3018).

Read the Regulatory Relief Coalition Press Release

Read what the bill’s sponsors have to say.

About RRC

The Regulatory Relief Coalition (RRC) is a group of national physician specialty organizations advocating for regulatory burden reduction in Medicare so that physicians can spend more time treating patients.

Most recently, we have focused on common sense reform of Medicare Advantage plans use of prior authorization. Our aim is to ensure that prior authorization is not a barrier to timely access to care for the patients we serve.