Improving Seniors’ Timely Access to Care Act of 2025
House Bill Would Require Medicare Advantage Plans to Speed Up Treatment Approvals for Seniors
Stalled
No legislative action in over 90 days.
Legislative Progress
Key Points
- This bill changes how private Medicare plans handle "prior authorization." This is the process where a doctor must ask an insurance company for permission before providing certain medical tests, surgeries, or treatments to a patient.
- Starting in 2028, insurance companies would be required to use a secure electronic system to handle these requests. This aims to replace slow, old-fashioned methods like fax machines and phone calls that often delay a patient's care.
- Beginning in 2027, insurance companies must report data to the government showing how often they approve or deny care. They will also have to disclose if they use artificial intelligence (AI) to make these decisions and exactly how many hours it takes them to respond to doctors.
- The policy encourages "real-time" decisions for common medical services that are routinely approved. It also allows insurance companies to skip the approval process for doctors who have a long history of following medical guidelines.
- The goal is to stop insurance paperwork from getting in the way of necessary medical care. By making the process faster and more transparent, the bill seeks to ensure seniors get their treatments without waiting days or weeks for a response.
Impact Analysis
Personal Impact
Life & Work
Small medical practices and healthcare providers spend significant staff time on prior authorization paperwork — phone calls, faxes, and portal submissions. The bill's requirement for standardized electronic submission could reduce this administrative burden, freeing up staff time and lowering overhead costs, especially for smaller practices that lack dedicated billing departments.
Programs
Disabilities
Milestones
Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Sent to a congressional committee for expert review. The committee decides whether this bill moves forward.
Introduced in House
The bill was officially filed and given a number. It now enters the legislative queue.
Votes
No votes have been recorded for this legislation yet.
Related News
3 articles
Now is time to reform prior authorization in Medicare Advantage
A bipartisan bill with overwhelming support from over 120 medical groups aims to codify protections for seniors. The legislation requires Medicare Advantage plans to implement electronic prior authorization and report approval/denial rates to CMS to ensure medical decisions are transparent.
Radiology groups renew push for bill to reform prior authorization
The Timely Access to Care Act would require Medicare Advantage plans to implement electronic systems instead of faxes. It also mandates public reporting of denial data and disclosure of AI use in coverage determinations, aiming to reduce the 93% of physicians reporting care delays.
Here's Why Medicare Advantage Fails America's Elderly
Medicare Advantage is under scrutiny for delays and denials that harm seniors. A growing consensus points to the need for reform, including the Improving Seniors’ Timely Access to Care Act, to ensure greater transparency and protection for vulnerable populations against administrative red tape.
Source Information
Document Type
Congressional Bill
Official Title
Improving Seniors’ Timely Access to Care Act of 2025
Data Sources
Sponsor
Cosponsors
(250)Analysis generated by AI. Always verify with official sources.