SHM Supports the Reauthorization of the Improving Seniors' Timely Access to Care Act
June 14, 2024
SHM's Policy Efforts
SHM supports legislation that affects hospital medicine and general healthcare, advocating for hospitalists and the patients they serve.
The Honorable Roger Marshall
United States Senate
479A Russell Senate Office Building
Washington, DC 20510
The Honorable Krysten Sinema
United States Senate
317 Hart Senate Office Building
Washington, DC 20510
The Honorable John Thune
United States Senate
511 Dirksen Senate Office Building
Washington, DC 20510
The Honorable Sherrod Brown
United States Senate
503 Hart Senate Office Building
Washington, DC 20510
Dear Senators Marshall, Sinema, Thune, and Brown,
The Society of Hospital Medicine (SHM), representing the nation's hospitalists, is writing to offer our support for the reintroduction of the Improving Seniors' Timely Access to Care Act (S. 4532). This legislation will help protect patients from unnecessary delays in care by streamlining and standardizing prior authorization under the Medicare Advantage (MA) program.
Hospitalists are front-line physicians in America's acute care hospitals and focus on the general medical care of hospitalized patients. Many hospitalists report that prior authorization policies in MA plans result in delays of care, oftentimes among the most medically fragile patients and those requiring post-discharge care. Patient experiences include unnecessary waits for admission to skilled nursing facilities (SNFs) or rehab facilities and delayed discharges from the hospital while waiting for medication approvals. These delays prevent timely and safe transitions of care and exacerbate hospital access and capacity issues for other patients.
This legislation will help improve efficiency, transparency, and accountability of the prior authorization process in Medicare Advantage plans. Approximately half of all Medicare beneficiaries are enrolled in Medicare Advantage plans, and of those, four out of five enrollees are in plans that require prior authorization for some services. As enrollment in these plans increases, we must ensure that clinicians are not saddled with increasingly excessive administrative burdens. Most importantly, patients must be able to access physician recommended care or medications in a timely manner.
By creating more transparency and accountability around prior authorization, the Improving Seniors' Timely Access to Care Act would prioritize the needs of patients and reduce time-consuming prior authorization interactions between clinicians and MA plans. SHM is pleased to support this legislation and stands ready to help support its passage.
Sincerely,
Flora Kisuule, MD, MPH, SFHM
President, Society of Hospital Medicine