Rep. Suzan DelBene Champions Improved Access to Care for Seniors and Streamlined Prior Authorization Process

Improving Seniors' Timely Access to Care Act

Rep. Suzan DelBene is leading the charge in advocating for improved healthcare for seniors with her sponsorship of the Improving Seniors' Timely Access to Care Act. The legislation is designed to ease the burden on clinicians by mandating that affected health plans establish an electronic prior authorization process. This process would issue real-time decisions on services and procedures that are routinely approved, speeding up the time it takes for patients to receive the care they need.

While the Centers for Medicare and Medicaid Services (CMS) have issued a final rule that addresses many of the provisions outlined in the act, there is room for improvement. Specifically, DelBene believes that the decision-making process could be expedited further. This would result in an even more efficient healthcare system, particularly for commercial health plans.

Streamlining the Prior Authorization Process

The CMS rule is seen as a significant step forward for seniors and their families. Representatives Mike Kelly, Suzan DelBene, Ami Bera, Larry Bucshon, Senators Roger Marshall, Sherrod Brown, John Thune, and Kyrsten Sinema have welcomed the regulations. The new rules are designed to eliminate unnecessary delays and denials caused by prior authorization, thus enabling healthcare providers to focus more on delivering quality care.

The Improving Seniors' Timely Access to Care Act, led by Rep. Kelly, is aimed at modernizing and streamlining the prior authorization process for the nearly 32 million Americans enrolled in Medicare Advantage. The Biden administration has also finalized a rule aimed at streamlining health plans' use of prior authorization. This rule requires Medicare Advantage organizations, Medicaid, and other government-sponsored health programs to respond quickly to prior authorization requests and provide specific reasons for denying requests.

Improving Care for Kidney Patients

DelBene is also committed to improving care for kidney patients. She advocates for expanded access to home dialysis, which offers patients more flexibility and comfort compared to in-center dialysis. DelBene is also a proponent of research into artificial kidneys, which could revolutionize treatment for patients with kidney failure.

Addressing Cuts to the Medicare Physician Fee Schedule

Another concern highlighted by DelBene is the ongoing issue of cuts to the Medicare physician fee schedule. This has resulted in a decline in physician payment, which could potentially impact the quality and accessibility of care for seniors. As such, DelBene is calling for a permanent solution to address this problem and ensure that physicians are fairly compensated for their services.

In conclusion, Rep. Suzan DelBene is actively working towards better healthcare for seniors and a more efficient healthcare system. Her focus on streamlining the prior authorization process, expanding access to home dialysis, promoting research on artificial kidneys, and addressing the issue of physician payment cuts, showcases her commitment to improving the healthcare landscape for all.