ASTRO applauds legislation on 'real-time' prior authorizations

By AuntMinnie.com staff writers

September 15, 2022 -- The American Society for Radiation Oncology (ASTRO) is applauding passage of legislation in the U.S. House of Representatives intended to revamp Medicare Advantage prior authorization practices.

Under the Improving Seniors' Timely Access to Care Act of 2021, Medicare Advantage plans will be required to establish an electronic prior authorization program that meets specified standards, including the ability to provide real-time decisions in response to requests for items and services that are routinely approved.

If also passed in the Senate, ASTRO said the legislation could have a significant impact on radiation oncology practices, as prior authorization is consistently ranked by radiation oncologists as a major challenge. Nine in 10 radiation oncology practice leaders say their patients are delayed from cancer treatment due to prior authorization, and a majority say the average delay lasts a week or longer, according to ASTRO.

"This legislation is an essential step in the effort to reform the broken prior authorization system," said Dr. Laura Dawson, chair of the ASTRO board of directors, in a news release.

The legislation was introduced in May 2021 by Representatives Suzan DelBene (D-WA), Mike Kelly (R-PA), Dr. Ami Bera (D-CA), and Dr. Larry Bucshon (R-IN).


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