American College of Rheumatology Applauds Reintroduction of Legislation to Reform Prior Authorization Policies
ATLANTA – The American College of Rheumatology (ACR), representing more than 9,100 rheumatologists and rheumatology professionals, applauds the reintroduction of the bipartisan, bicameral Improving Seniors Timely Access to Care Act by U.S. Senators Sherrod Brown (OH), Roger Marshall (KS), Kyrsten Sinema (AZ), and John Thune (SD) as well as Congressmen Ami Bera (CA-6), Larry Bucshon (IN-8), Suzan DelBene (WA-1), and Mike Kelly (PA-16).
“The prior authorization process has become unmanageable for both doctors and patients. Insurer red tape imposes a significant burden on clinicians, leading to unnecessary and unclear delays, or even outright denials of patient care,” shared Dr. Deborah Dyett Desir, president of the ACR. She also praised the legislative efforts to address these issues: "We applaud lawmakers' leadership in pushing legislation that streamlines the prior authorization process. This bill enhances transparency and urges insurers to adopt evidence-based medical guidelines in their prior authorization decisions."
The new bill is based on legislation that unanimously passed the U.S. House of Representatives and garnered over 50 Senate co-sponsors in the last Congress. The Improving Seniors Timely Access to Care Act of 2024 includes changes to reflect policies implemented by CMS since the last attempt at passage, which have the benefit of reducing the legislation's Congressional Budget Office (CBO) score – the stumbling block for the Senate in the 117th.
Payers use prior authorization to limit or control access to specific medical treatments and services, often defaulting to denial of treatments that are ultimately approved in over 95% of cases. Since the requirements for prior authorization are not uniform, the process frequently involves hours of paperwork and administrative strain for physicians and healthcare professionals, often preventing patients from promptly accessing their best treatment options.
"ACR stands united with hundreds of physicians, patients, hospitals, and other key stakeholders in endorsing this bill," Dr. Desir stated. "This legislation represents a crucial initial step toward alleviating the burdensome prior authorization process. We strongly urge Congress to act swiftly and pass this bill," she concluded.
Media Contact
Monica McDonald
mmcdonald@rheumatology.org
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The American College of Rheumatology (ACR) is an international medical society representing over 9,100 rheumatologists and rheumatology health professionals with a mission to empower rheumatology professionals to excel in their specialty. In doing so, the ACR offers education, research, advocacy, and practice management support to help its members continue their innovative work and provide quality patient care. Rheumatologists are experts in the diagnosis, management, and treatment of more than 100 different types of arthritis and rheumatic diseases.