Prior Authorization Reform Bill Reaches House Fast-Track Eligibility with Broad Bipartisan Support

The "Improving Seniors' Timely Access to Care Act," sponsored by Rep. Mike Kelly (R-Pa.), has achieved the 290 co-sponsor threshold needed for House consensus calendar consideration, a fast-track process for broadly supported legislation. The bill targets prior authorization practices in Medicare Advantage plans, which now cover more than half of Medicare beneficiaries, by requiring insurers to implement electronic systems using standardized transactions to reduce delays caused by navigating multiple payer portals or faxing information. The legislation also mandates that plans submit data to the federal government on which services require prior authorization and approval/denial rates. Originally introduced in 2019 by Rep. Suzan DelBene (D-Wash.), the bill has garnered support from patient groups, provider organizations, and even some Medicare Advantage insurers, with a companion Senate measure sponsored by Sen. Roger Marshall (R-Kan.) attracting 70 co-sponsors. Despite this unprecedented bipartisan consensus and a Congressional Budget Office score showing no cost to the government, the bill has stalled for multiple congressional sessions, with sponsors and advocates unable to identify clear reasons for the delay beyond general congressional distraction with other priorities.