Improving Seniors’ Timely Access to Care Act of 2025
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Progress
Where this bill stands in the legislative process.
- Introduced
- Passed Senate
- Passed House
- To President
- Became Law
Overview
This bill, the Improving Seniors’ Timely Access to Care Act of 2025, aims to reduce delays in Medicare Advantage plans related to prior authorization requirements for medical services. It mandates the creation of an electronic prior authorization program, increases transparency regarding these requirements, and establishes timelines for responses to prior authorization requests. The bill also seeks to improve enrollee access to information about prior authorization processes and outcomes.
Key provisions
- Establishes an electronic prior authorization program for Medicare Advantage plans.
- Requires Medicare Advantage plans to submit annual data on prior authorization requests and decisions to the Secretary.
- Sets timelines for responses to prior authorization requests, with potential for expedited determinations.
- Promotes transparency by requiring plans to disclose criteria for prior authorization decisions to providers and enrollees.
- Mandates the creation of ‘real-time decisions’ for routinely approved items and services.
- Requires Medicare Advantage plans to consult with enrollees and providers in developing prior authorization programs.
- Establishes a process for annual reviews of prior authorization requirements.
- Directs the GAO to evaluate the implementation of the bill and the Medicare Payment Advisory Commission to report on issues related to prior authorization.
Who is affected
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