House Subcommittee Advances Prior Authorization Legislation

The House of Representatives Energy and Commerce Subcommittee on Health has advanced the Improving Seniors’ Timely Access to Care Act (H.R. 3514), a major legislative milestone for reform of Medicare Advantage (MA) prior authorization practices.

H.R. 3514 would cement into law regulations issued by the Centers for Medicare & Medicaid Services in 2024. Importantly, the legislation would expand on those regulations by requiring MA plans to report prior authorization data – including the number of approvals and denials by item and service – which would then be made publicly available.

ASNC’s 2026 Capitol Hill delegation talked with policymakers about the impact of burdensome prior authorization requirements on patients’ access to care.

This spring, for the first time, MA and other plans were required to make prior authorization data publicly available. Those data, however, are often difficult to find on plan websites, reported in inconsistent formats, and aggregated at a level too high to show what is happening to specific services. H.R. 3514 would streamline transparency requirements and make the information more usable.

The legislation has the support of more than half of Congress and is endorsed by 300+ organizations, including ASNC. Last month, ASNC sent a delegation of 19 physicians to Capitol Hill, where they met with the legislative staff of 66 congressional offices about H.R. 3514 and other advocacy priorities. ASNC encourages members to keep up advocacy efforts in support of the bill. Contact Congress through the ASNC Action Center.

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