Washington DC Snapshot: What’s Happening in Congress on Critical Health Care Legislation

September 28, 2022 3:07 PM | Anonymous
  • The Improving Seniors’ Timely Access to Care Act, a top legislative priority for the American Academy of Ophthalmology (AAO) that would reform prior authorization in Medicare Advantage plans, was unanimously passed the U.S. House of Representative earlier this month and is now under further consideration by the Senate.

    Providing much-needed oversight and transparency while protecting beneficiaries from unnecessary care delays and denials, the bill would require Medicare Advantage plans to:
    • Establish an electronic prior authorization program.
    • Standardize and streamline the prior authorization process for routinely approved services, including establishing a list of services eligible for real-time prior authorization decisions.
    • Ensure prior authorization requests are reviewed by qualified medical personnel.
    • Increase transparency around Medicare Advantage prior authorization requirements and their use.

      The AAO is actively advocating in Congress for swift passage of the bill.
  • The Supporting Medicare Providers Act of 2022 was recently introduced in Congress to counteract pending  budget neutrality cuts to the Medicare Physician Fee Schedule. More specifically, the legislation would prevent a 4.5% cut to Medicare physician payments set to go into effect next year. The bipartisan legislation – introduced by physician Congressmen Ami Bera, M.D., (D-CA) and Larry Bucshon, M.D. (R-IN) – would also encourage the implementation of a longer-term solution to promote and reward value-based payments and advance health equity.


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Wisconsin Academy of Ophthalmology

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Ph: 920-560-5645 • WAO@badgerbay.co

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