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Improving Seniors’ Timely Access to Care Act of 2024

H.R. 8702 Rep. Mike Kelly (R-PA-16) In committee
Bill text PDF
  1. Introduced Jun 12
  2. Committee Jun 12
  3. Passed House Next
  4. Passed Senate Not yet
  5. To President Not yet
  6. Law Not yet
Where it stands
In committee, Jun 12, 2024Next: House vote
680d ago Dec 17, 2024: Referred to the Subcommittee on Health.
Final votes
No roll callsNo recorded vote on this bill yet
Lobbying
5companies, 7 filings
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Summary

This bill amends the Social Security Act to establish new requirements for how Medicare Advantage plans use prior authorization. It mandates electronic prior authorization programs, transparency reporting, and enrollee protection standards, and gives the Secretary of Health and Human Services authority to set response timeframes for prior authorization requests.

Sec. 2, Establishing requirements for prior authorization under Medicare Advantage plans: This section adds a new subsection to the Social Security Act requiring Medicare Advantage plans that use prior authorization to establish an electronic prior authorization program starting with plan years beginning on or after January 1, 2027. This program must allow secure electronic transmission of prior authorization requests and responses, excluding faxes, proprietary payer portals that don't meet standards, or electronic forms. Starting with plan years beginning on or after January 1, 2026, plans must meet transparency requirements, including annually submitting to the Secretary a list of items and services subject to prior authorization, approval and denial rates, appeal data, use of technology like AI, average response times, and other information. Plans must also provide criteria and documentation requirements to providers and enrollees. The Secretary must publish this information on a public CMS website. The Medicare Payment Advisory Commission must report on this information within 3 years. Enrollee protection standards require transparent programs developed with enrollees and providers, allowing waiver of prior authorization based on provider performance, and annual reviews of prior authorization requirements. The term 'applicable item or service' excludes Part D drugs. The Comptroller General must report on implementation by January 1, 2028, and the Secretary must submit biennial reports starting after the fifth plan year. CMS and the Office of National Coordinator must report by January 1, 2027, on real-time decisions for routinely approved services.

Sec. 2(b), Providing the Secretary authority to enforce timely responses: This part amends existing law to allow the Secretary to establish timeframes, such as 24 hours, for responding to prior authorization requests, including expedited requests, real-time decisions for routinely approved items and services, and any other prior authorization requests.

Summary of the bill text as introduced in House (Jun 12, 2024), generated by SecBot from the official bill text; the Library of Congress summary is not yet published.

Official record from Congress.gov, the House Clerk and the Senate; lobbying from Lobbying Disclosure Act filings. Updated Oct 28, 2026.