Rep. Mark Green, MD, a Republican from Tennessee, reintroduced a bill to Congress that would reform prior authorization requirements, The Hill reported March 27.
“As a survivor of both colon and thyroid cancer, I know how critical it is to start treatment as soon as possible,” Dr. Green told the news outlet. “Prior authorization can be a roadblock that costs lives. Doctors need to be able to make fast, life-saving decisions without a jungle of red tape to cut through.”
Here are four things to know about the bill:
1. The bill would change Medicare and Medicare Advantage to require that board-certified physicians in the same specialty are responsible for determining the medical need of prior authorization requests.
2. It also would direct Medicare, Medicare Advantage and Medicare Part D plans to comply with requirements that prior authorization restrictions must be based on medical necessity, written clinical criteria and additional transparency obligations.
3. The bill has been endorsed by the American Medical Association, the American Osteopathic Association, the American College of Emergency Physicians and the American Academy of Family Physicians.
4. Rep. Greg Murphy, MD, a Republican from North Carolina, and Rep. Kim Schrier, MD, a Democrat from Washington, co-sponsored the bill.
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