PAN Foundation statement: Reintroduction of the Improving Seniors’ Timely Access to Care Act
The Patient Access Network (PAN) Foundation applauds U.S. Senators Roger Marshall, MD (R-KS), Kyrsten Sinema (I-AZ), John Thune (R-SD), Sherrod Brown (D-OH), and U.S. Representatives Mike Kelly (R-PA), Suzan DelBene (D-WA), Larry Bucshon, MD (R-IN) and Ami Bera, MD (D-CA) for reintroducing the Improving Seniors’ Timely Access to Care Act last week. This bipartisan, bicameral legislation streamlines the prior authorization process under Medicare Advantage (MA), allowing seniors to get the care they need and helping healthcare providers put patients over paperwork.
The bill is supported by over 370 national and state organizations representing patients, physicians, MA plans, hospitals, and other key stakeholders in the healthcare industry. The PAN Foundation is proud to be one of these supporting organizations.
The Improving Seniors’ Timely Access to Care Act of 2024 would mandate that MA plans comply with enhanced transparency reporting requirements starting in January 2026 and implement electronic modernization requirements beginning in January 2027. Specifically, the bill 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 Center for Medicare and Medicaid Services’ (CMS) authority to establish timeframes for e-PA requests including expedited determinations, real-time decisions for routinely approved items and services, and other PA requests.
- Expand beneficiary protections to improve enrollee experiences and outcomes.
- Require the U.S. Department of Health and Human Services (HHS), and other agencies, report to Congress on program integrity efforts and other ways to further improve the electronic prior authorization process.
“We are grateful to see the continued focus on improving the prior authorization process for millions of patients enrolled in Medicare Advantage plans,” said Amy Niles, Chief Mission Officer of the PAN Foundation. “We know that prior authorization often delays access to treatment for many due to the time-consuming nature of the process for both patients and healthcare providers. The Improving Seniors’ Timely Access to Care Act of 2024 is a step in the right direction. With our recent polling showing that nearly half of insured adults have faced prior authorization requirements in the past year, we also remain hopeful that future prior authorization legislation can include prescription medications, extend to all patients regardless of insurance type, and address requirements related to the rationale for applying prior authorization, clinical coverage criteria, and the use of automated processes—including artificial intelligence.”
The PAN Foundation is committed to urging Congress, along with public and private insurers, to curb restrictive utilization management practices, like prior authorization. For more information about this and PAN’s other key policy positions, visit: panfoundation.org/our-positions.
About the Patient Access Network Foundation
The PAN Foundation is an independent, national 501 (c)(3) organization dedicated to helping federally and commercially insured people living with life-threatening, chronic, and rare diseases with the out-of-pocket costs for their prescribed medications.
Since 2004, we have provided more than 1.2 million underinsured patients with over $4 billion in financial assistance. Partnering with generous donors, healthcare providers and pharmacies, we provide the underinsured population access to the healthcare treatments they need to best manage their conditions and focus on improving their quality of life. Learn more at panfoundation.org.