Improving Seniors' Timely Access to Care Act - Transparency in Medicare Advantage

The Improving Seniors' Timely Access to Care Act, aimed at tackling AI-driven prior authorization delays in Medicare Advantage plans, recently received approval from the House Ways & Means Health Subcommittee. This crucial legislation seeks to enhance transparency and accountability in the insurance sector. It now awaits further approval from the full Ways & Means and House Energy & Commerce Committees before proceeding to a House floor vote.

Legislative counsel for the Regulatory Relief Coalition, Peggy Tighe, remains optimistic about the bill's passage despite the House's scheduling challenges. She stressed the importance of advancing this measure before the August recess, noting its broad support and the fact that it incurs no additional cost.

The bill, initially introduced by Rep. Mike Kelly in May 2025, has garnered substantial bipartisan backing with 296 House cosponsors from both parties. A parallel bill in the Senate led by Sen. Roger Marshall also enjoys strong bipartisan support, indicating a shared interest in reform.

This legislation targets key areas such as greater transparency in prior authorization denials by Medicare Advantage plans and mandates public reporting of denial records by the Centers for Medicare & Medicaid Services (CMS). The bill also promotes the electronic implementation of prior authorization, receiving detailed reports and scrutiny from the Medicare Payment Advisory Commission (MedPAC) and the Government Accountability Office.

With a complex history, the bill was first introduced in 2019, reintroduced in 2021, and despite passing the House, it stalled in the Senate. Initially prospecting a cost of $16.2 billion over a decade, regulatory changes reduced this to $4 billion, with the latest adjustments bringing it to zero. These changes followed the Biden administration's regulatory timeline mandates in January 2024.

Highlighting the importance of legislative support over mere regulatory efforts, Tighe noted several critical provisions absent from current regulations. These include compelling CMS, instead of insurers, to publicly disclose transparency data, making it more accessible for seniors. Rep. Suzan DelBene also voiced strong support, urging for an expedited House vote, underscoring the bipartisan consensus and highlighting the reduction of administrative burden.

In praising the legislation's advancement, the American Medical Association and representatives from Premier emphasized the need to modernize processes and minimize administrative strain. A survey by Premier indicates that Medicare Advantage prior authorization delays impose a staggering $19.7 billion annual management cost on providers. These reforms aim to enhance the quality and efficiency of care for seniors, aligning with the industry's regulatory compliance objectives.