Rep. Green Reintroduces Bill to Protect Patients From Delays in Medical Care

WASHINGTON—Today, Rep. Mark Green, M.D., re-introduced his Reducing Medically Unnecessary Delays in Care Act to address the use of prior authorization requirements in Medicare and Medicare Advantage, as well as prior authorization fixes to prescription drug plans under Medicare. 

Green said, “A physician should be the one determining a patient’s course of treatment. Prior authorization is a roadblock to care—equivalent to a bureaucrat in the waiting room. Medicare and Medicare Advantage plan administrators should not be able to exercise a unilateral veto over a doctor’s prescribed treatment. It is this kind of red tape that creates frustration for healthcare providers and patients alike. We know that preauthorization leads to delays in care and worse health outcomes for patientsit’s time to put patients first. Preauthorization doesn’t do that.”

Background: The Reducing Medically Unnecessary Delays in Care Act would reform the practice of prior authorization in Medicare and Medicare Advantage by requiring that board-certified physicians in the relevant specialty are the ones making these important decisions. It would also direct Medicare, Medicare Advantage, and Medicare Part D plans to comply with requirements that restrictions must be based on medical necessity and written clinical criteria, as well as additional transparency obligations. Additionally, the legislation fixes prior authorization in prescription drug plans under Medicare.

Read the bill here.