Take Action on Prior Authorization Bill Before January 22
by ACOI
January 20, 2026
Supporters of the Improving Seniors’ Timely Access to Care Act (Seniors’ Act) are ramping up grassroots advocacy in advance of House congressional hearings with insurance company executives to ensure that prior authorization is a centerpiece of the hearings. ACOI members are encouraged to email their members of Congress prior to January 22 to express support for the bill which would reduce barriers to patient care and ease physician burden associated with Medicare Advantage (MA) plans’ prior authorization requirements. Taking action is easy through the ACOI Action Center.
TAKE ACTION
The Seniors’ Act (S. 1816 and H.R. 3514), which has been endorsed by more than 300 other organizations, including ACOI, would codify and enhance elements of the Advancing Interoperability and Improving Prior Authorization Processes rule that was finalized by the Centers for Medicare and Medicaid Services on January 17, 2024.
Specifically, the legislation:
- Establishes an electronic prior authorization process for MA plans, including standardization of transactions and clinical attachments.
- Increases transparency around MA prior authorization requirements and their use.
- Provides a pathway for CMS to institute real-time decisions for routinely approved items and services in the future and clarify CMS’ authority to establish timeframes for e-PA requests, including expedited determinations, real-time decisions for routinely approved items and services and any other PA requests.
- Expands beneficiary protections to improve enrollee experiences and outcomes.
- Requires the U.S. Department of Health and Human Services and other agencies to report to Congress on program integrity efforts and other ways to improve the e-PA process.