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116th Congress Legislation

H.R. 3107 – Improving Seniors’ Timely Access to Care Act of 2019

RRC supports H.R. 3107, the Improving Seniors’ Timely Access to Care Act, a bill that would…

  • Establish an electronic prior authorization process;
  • Minimize the use of prior authorization for routinely approved services;
  • Ensure prior authorization requests are reviewed by qualified medical personnel;
  • Require regular reports from Medicare Advantage plans on their use of prior authorization and rates of delay and denial; and
  • Prohibit the use of prior authorization for medically-necessary services performed during pre-approved surgeries or other invasive procedures.

H.R. 3107 was introduced by Reps. Suzan DelBene (D-WA), Mike Kelly (R-PA), Roger Marshall, MD (R-KS), and Ami Bera, MD (D-CA). This bipartisan legislation would help protect patients from unnecessary delays in care by streamlining and standardizing prior authorization under the Medicare Advantage program, providing much-needed oversight and transparency of health insurance for America’s seniors. Read two “Dear Colleague” letters sent on June 3rd  and July 27th from the bill’s champions encouraging other Members to co-sponsor the bill.

Based on a consensus statement on prior authorization reform adopted by leading national organizations representing physicians, medical groups, hospitals, pharmacists, and health plans, the legislation would facilitate electronic prior authorization, improve transparency for beneficiaries and providers alike, and increase Centers for Medicare & Medicaid Services (CMS) oversight on how Medicare Advantage plans use prior authorization. Over 100 members of Congress called for such reform in a bipartisan letter to CMS in 2018. The letter was led by Representatives David P. Roe (R-TN) and Ami Bera (D-CA).

Original Sponsors

Suzan DelBene

Washington, 1st District

Mike Kelly

Pennsylvania, 16th District

Roger Marshall

Kansas, 1st District

Ami Bera

California, 7th District