RRC Endorsed Legislation

Electronic Prior Authorization for Prescription Drugs Act

The Electronic Prior Authorization for Prescription Drugs Act would establish a secure electronic prior authorization process for prescription drug plans in the commercial market. By providing a secure electronic transmission of these requests, this bill would streamline the process, reduce administrative burdens on health care providers, and ensure that patients receive timely access to necessary medications. This legislation is significant for individuals with chronic conditions who rely on consistent medication management to maintain their health.

No Fees for EFTs Act

The No Fees for EFTs Act would prohibit health plans from imposing fees on health care providers for electronic funds transfers (EFTs) and health care payments and remittance advice transactions. Under the Affordable Care Act, insurance carriers must offer providers the ability to receive reimbursements electronically. However, many insurers partner with third-party vendors that charge between two to five percent per EFT. According to the Medical Group Management Association (MGMA), nearly 60 percent of medical groups report being charged fees they did not agree to by insurers to receive electronic payments. RRC is pleased to support the No Fees for EFTs Act.

Reducing Medically Unnecessary Delays in Care Act of 2023

The Reducing Medically Unnecessary Delays in Care Act of 2023 would reform prior authorization in Medicare, Medicare Advantage, and Part D by requiring that all prior authorizations and adverse determinations must be made by a licensed physician who is board certified in the specialty relevant to the health care item or service requested. It would also require plans to create policies based on medical necessity and written clinical criteria. RRC applauds Representative Mark Green for introducing this legislation.