Bill passes To Improve Medicare Advantage Prior Authorization

The Private Practice section of the American Physical Therapy Association has been working tirelessly on many important issues facing patients and providers. Forward momentum has been building in the September before an election year!

In a move to improve transparency and accountability for Medicare Advantage (MA) plans, the House passed the Improving Seniors’ Timely Access to Care Act (S.3018/H.R.3173). This bill seeks to ensure that seniors receive timely access to care by improving the prior authorization process for Medicare Advantage plans. The American Physical Therapy Association (APTA) applauds Congress for taking this important step to improve Medicare beneficiaries’ access to quality physical therapy services.

Medicare Advantage plans are required to use prior authorization for certain services, including physical therapy. However, the process is often cumbersome and time-consuming, resulting in delays in care for Medicare beneficiaries. The Improving Seniors’ Timely Access to Care Act seeks to address these issues by requiring Medicare Advantage plans to provide greater transparency around their prior authorization policies and procedures. In addition, the bill would establish an appeals process for Medicare beneficiaries who are denied coverage for services.

The APTA is committed to ensuring that Medicare beneficiaries have timely access to quality physical therapy services. We believe that the Improving Seniors’ Timely Access to Care Act is a step in the right direction to achieving this goal. We urge the Senate to take up this important legislation and pass it into law. Medicare beneficiaries deserve nothing less.

The bill now goes to the Senate for passage. This legislation (which is free from federal spending, has incredible and wide-spread stakeholder support, has obtained 323 cosponsors in the House and has 42 cosponsors in the Senate) has a good chance of passing the Senate and becoming law. Medicare beneficiaries who need prior authorization for physical therapy services would greatly benefit if Congress enacts this legislation.

APTA will continue to provide updates as this process moves forward. In the meantime, you can contact your Senators and urge them to support S.30183173/H.R. improve Medicare Advantage’s prior authorization process by passing the Improving Seniors’ Timely Access to Care Act. You can find contact information for your Senators here. Whether you are a physical therapist, a practice owner, a patient, or a member of the community that is looking for improvements to our healthcare; voicing your support for this bill will go a long way!