U.S. Medicare Advantage Prior Authorization Reform Advances in Congress

The House Committee on Ways and Means advanced the Improving Seniors' Timely Access to Care Act (H.R. 3514/S. 1816), a bipartisan bill that would modernize prior‑authorization requirements for Medicare Advantage plans. The legislation calls for electronic prior‑authorization, greater transparency and streamlined determinations, aiming to improve access for more than 35 million seniors, people with disabilities and veterans enrolled in Medicare Advantage.

Separately, the Senate rejected a Democratic‑led proposal to end a Medicare pilot that uses artificial intelligence for prior‑authorization decisions in original Medicare. The vote, 46‑50 along party lines, blocked the effort to halt the AI test known as WISeR, which had been promoted by the White House as a way to reduce prior‑authorization burdens.

Both actions reflect ongoing partisan debate over how to reform prior‑authorization practices across Medicare programs.