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Kaine Reintroduces Bipartisan Bill to Cut Health Care Wait Times for Older Americans

WASHINGTON, D.C. —U.S. Senator Tim Kaine (D-VA), a member of the Senate Health, Education, Labor and Pensions (HELP) Committee, joined a bipartisan, bicameral group of colleagues in reintroducing the Improving Seniors’ Timely Access to Care Act, legislation that would streamline the prior authorization process under Medicare Advantage (MA) plans to allow older Americans to get the care they need faster and to help health care providers prioritize patients over paperwork.  

Prior authorization is a leading cause of administrative burden as identified by health care providers. Prior authorization is a tool used by health plans that requires providers to get pre-approval for medical services, which can result in lapses of communication between clinicians and insurance companies and longer wait times for patients. This legislation would streamline prior authorization processes for patients on MA plans to ensure patients can access medical services in a timely manner.

“Older Americans shouldn’t be forced to wait to get critical care because their providers are busy dealing with a mountain of paperwork,” said Kaine. “This bipartisan legislation would streamline health care processes to ensure that Americans covered by Medicare Advantage can access the care they need more quickly and enable doctors and health care providers to direct more of their time to their patients.”

The Improving Seniors’ Timely Access to Care Act would enable health care professionals to better serve patients and reduce unnecessary administrative burdens. Specifically, it would:

  • Establish an electronic prior authorization process for MA plans including a standardization for transactions and clinical attachments.
  • Increase transparency around MA prior authorization requirements and its use.
  • Clarify the Centers for Medicare and Medicaid Services’ authority to establish timeframes for electronic prior authorization requests including expedited determinations, real-time decisions for routinely approved items and services, and other prior authorization requests.
  • Expand beneficiary protections to improve enrollee experiences and outcomes.
  • Require the U.S. Department of Health and Human Services and other agencies to report to Congress on program integrity efforts and other ways to further improve the electronic prior authorization process.

Across Virginia and the nation, health care professionals are experiencing an increase in burnout following the COVID-19 pandemic, and high administrative burdens are a direct contributing factor, according to the 2022 U.S. Surgeon General report. To combat this, Kaine has introduced multiple bills to address burnout among health care professionals and increase access to mental health resources, including the Dr. Lorna Breen Health Care Provider Protection Act—legislation that was signed into law to expand mental health services for health care workers to prevent suicide, burnout, and mental health conditions. Last month, Kaine spearheaded the Dr. Lorna Breen Health Care Provider Protection Reauthorization Act to extend those resources.

In addition to Kaine, the legislation is cosponsored by U.S. Senators Roger Marshall (R-KS), Kyrsten Sinema (I-AZ), John Thune (R-SD), Sherrod Brown (D-OH), Marsha Blackburn (R-TN), Sheldon Whitehouse (D-RI), Bill Cassidy, M.D. (R-LA), Maggie Hassan (D-NH), Thom Tillis (R-NC), Tom Carper (D-DE), John Cornyn (R-TX), Bob Casey (D-PA), John Boozman (R-AR), Debbie Stabenow (D-MI), Jerry Moran (R-KS), Amy Klobuchar (D-MN), J.D. Vance (R-OH), Kirsten Gillibrand (D-NY), Tedd Budd (R-NC), Josh Hawley (R-MO), Jeanne Shaheen (D-NH), Cindy Hyde-Smith (R-MS), Mark Kelly (D-AZ), Kevin Cramer (R-ND), Jacky Rosen (D-NV), Mike Braun (R-IN), Martin Heinrich (D-NM), Eric Schmitt (R-MO), John Hickenlooper (D-CO), Marco Rubio (R-FL), Gary Peters (D-MI), Mike Rounds (R-SD), Peter Welch (D-VT), John Hoeven (R-ND), Alex Padilla (D-CA), Richard Blumenthal (D-CT), Raphael Warnock (D-GA), Brian Schatz (D-HI), Jeff Merkley (D-OR), John Fetterman (D-PA), and Elizabeth Warren (D-MA). The legislation is being led in the U.S. House of Representatives by U.S. Representatives Mike Kelly (R-PA-16), Suzan DelBene (D-WA-01), Larry Bucshon, M.D. (R-IN-08), and Ami Bera, M.D. (D-CA-06).

Full text of the bill is available here.