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Medicare Advantage

Medicare Advantage Prior Authorization Reform Bill Clears Both House Committees Without Opposition

The Improving Seniors' Timely Access to Care Act passed Ways and Means 42 to 0 on July 15 and Energy and Commerce 45 to 0 on July 21, requiring Medicare Advantage plans to use electronic prior authorization and report approval data to CMS.

By the Goodsurance editorial teamJuly 25, 2026

Bipartisan legislation targeting delays in Medicare Advantage prior authorization has now passed both House committees with jurisdiction over the bill without a single opposing vote in either panel.

The Improving Seniors' Timely Access to Care Act, H.R. 3514, passed the House Committee on Ways and Means 42 to 0 on July 15, 2026. The House Committee on Energy and Commerce followed with a 45 to 0 vote on July 21. Both committees adopted an amendment that, among other changes, delays the bill's effective date to January 1, 2029.

HR 3514 on Medicare Advantage prior auth: two committees, two unanimous votes. Full House vote is next.

The bill would require Medicare Advantage plans to build electronic prior authorization programs, annually report data to CMS on approval rates and average response times, and apply gold-carding provisions that would exempt providers with consistently high approval histories from routine prior authorization for certain services.

Prior authorization is the insurer review step that must be completed before Medicare Advantage covers certain services, including hospitalizations and transitions to post-acute care settings such as skilled nursing facilities and inpatient rehabilitation. Oversight reviews have found that Medicare Advantage plans overturned a substantial proportion of initially denied requests when beneficiaries or providers appealed, raising concerns about whether some initial denials were warranted.

The bill now advances to the House floor for consideration by the full chamber. No Senate companion bill vote has been scheduled, and separate Senate action would be required before the legislation could be sent to the president.

In plain words

A bill to speed up and modernize the insurance pre-approval process in Medicare Advantage plans passed two House committees, both times with every member voting yes. The bill would require plans to use electronic systems and share data on how long approvals take. It still needs a full House vote and then Senate action before it becomes law.

Understand the basics first

Source: LeadingAge
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