Supporting Timely Access to Care for Seniors

August 9, 2024

Together with the American Medical Association’s Division of Congressional Affairs, the American College of Chest Physicians (CHEST) formally endorses the Improving Seniors’ Timely Access to Care Act.

The act aims to hold Medicare Advantage plans accountable for enhancing the efficiency and transparency of the prior authorization process through:

• Establishment of an electronic prior authorization program to facilitate the electronic transmission of prior authorization requests and responses between health care providers and the plans.
• Transparency requirements, including annually submitting detailed information to the Secretary of Health and Human Services, such as disclosure of policies and evidence, a list of items and services subject to prior authorization, and statistics on approval and denial rates.
• Reporting to Congress, including evaluations and analyses of real-time decision processes for routinely approved services.
• Timeframe for responses for notifying enrollees and clinicians of prior authorization determinations. This includes expedited determinations and real-time decisions for routinely approved services.

The overarching goal is to reduce delays in patient care under Medicare Advantage plans. In tandem, this act strives to reduce the tremendous administrative burden on the workforce, inclusive of CHEST membership.

Read the full act.