Senate Bill Would Standardize Medicare Advantage Prior Authorization Rules Across All Plans
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This bill’s path across every version that has carried it.
Scores run from -100 (strongly harmful) to +100 (strongly beneficial) for each group, combining impact, certainty, scope, and duration ratings of 1-5. How impact scoring works
Small medical practices and physician-owned clinics spend significant staff time navigating different prior authorization rules for each Medicare Advantage plan. Standardizing these requirements would reduce the administrative burden on these practices, allowing them to spend less money on paperwork staff and more time on patient care. However, this only applies to the subset of items and drugs identified in the audit.
Read twice and referred to the Committee on Finance.
Sent to a congressional committee for expert review. The committee decides whether this bill moves forward.
Introduced in Senate
The bill was officially filed and given a number. It now enters the legislative queue.
Senator Whitehouse's Prior Authorization Relief Act would require CMS to perform an audit of Medicare Advantage insurance plans and standardize requirements. The bill also exempts providers in two-sided risk value-based payment models from prior authorization for their beneficiaries.
The Prior Authorization Relief Act (S. 3762), introduced by Senator Sheldon Whitehouse, would require the Centers for Medicare and Medicaid Services (CMS) to streamline and standardize prior authorization for services in Medicare Advantage.
No votes or related bills recorded for this bill yet.
Document Type
Congressional Bill
Official Title
Prior Authorization Relief Act
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