Marshall’s bill to streamline healthcare paperwork passes House Committee

Published: Jul. 28, 2022 at 7:27 AM CDT
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TOPEKA, Kan. (WIBW) - A bill penned by Senator Roger Marshall to help prioritize patients over paperwork has been passed through the House Committee and now moves one step closer to becoming law.

On Wednesday, July 27, Senator Roger Marshall (R-Kan.) says the U.S. House Ways and Means Committee passed his legislation, the Improving Seniors’ Timely Access to Care Act. He said the bipartisan, bicameral legislation is meant to modernize Medicare Advantage to make health care delivery more patient and doctor friendly.

“For nearly four years, my colleagues and I have worked tirelessly on bipartisan legislation to modernize Medicare Advantage to better serve America’s seniors, said Senator Marshall “We reviewed comments from over 450 national and state organizations, took feedback from two Administrations, and worked collaboratively with House and Senate Committee leaders. Its significance to patients, health care providers, and innovators in medicine cannot be understated – this is the most supported health care bill in the entire Congress. I’m honored to have started this journey with Representatives Suzan DelBene, Mike Kelly, and Ami Bera years ago, and I am honored to continue working on this bill with Senators Kyrsten Sinema, John Thune, and Sherrod Brown. Today marks an important step forward. I urge leadership to prioritize moving our bipartisan, bicameral bill to the President’s desk.”

The announcement follows the signatures of more than 500 organizations that represent patients, doctors, hospitals and other key stakeholders in the healthcare industry to officially endorse the legislation.

Marshall said the bill was unanimously ordered out of Committee with several members who touted support for the action. During the markup, he said Rep. Suzan DelBene (D-WA) recognized his leadership during his time in the House chamber last Congress.

The Senator noted that prior authorization is a tool used by health plans to reduce spending from improper payments and unnecessary care by requiring doctors and other health care providers to get pre-approval for medical services. However, he said it is not without fault.

Currently, Marshall indicated that unconfirmed faxes of a patient’s medical information or phone calls by clinicians take away from delivering quality and timely care. He said this burden continues to be the largest administrative burden identified by providers and patients.

Recently, Marshall said the Office of the Inspector General at the U.S. Department of Health and Human Services raised concerns after an audit found that Medicare Advantage plans ultimately approved about 75% of requests that had originally been denied.

Marshall said health plans, health care providers and patients all agree that prior authorization needs to be improved to better help patients and reduce unnecessary administrative burdens for clinicians.

In fact, the Senator said leading health care organizations released a consensus statement to address some of the most pressing concerns about prior authorization. Building on these principles, he said the legislation would:

  • Establish an electronic prior authorization process to streamline approvals and denials
  • Establish national standards for clinical documents that would reduce administrative burdens for health care providers and Medicare Advantage plans
  • Create a process for real-time decisions for certain items and services routinely approved
  • Increase transparency that would improve communication channels and utilization between Medicare Advantage plans, health care providers and patients
  • Ensure appropriate care by encouraging Medicare Advantage plans to adopt policies that adhere to evidence-based guidelines
  • Require beneficiary protections that would ensure the electronic prior authorization serves seniors first

To read the full text of the legislation, click HERE.

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