H.R.3514 - Improving Seniors’ Timely Access to Care Act of 2025 (119th Congress)
Summary
H.R.3514, the "Improving Seniors’ Timely Access to Care Act of 2025," aims to amend Title XVIII of the Social Security Act, focusing on prior authorization requirements within Medicare Advantage plans. The bill mandates the establishment of electronic prior authorization programs and increased transparency regarding prior authorization processes. It also sets enrollee protection standards and requires reports to Congress on the implementation and impact of these changes.
Expected Effects
The bill will likely lead to more streamlined and transparent prior authorization processes within Medicare Advantage plans. This should improve seniors' access to necessary care by reducing delays and increasing clarity around authorization requirements. The electronic prior authorization program and transparency measures are intended to make the system more efficient and accountable.
Potential Benefits
- Improved access to care for seniors through more efficient prior authorization processes.
- Increased transparency in Medicare Advantage plans' prior authorization practices.
- Enhanced enrollee protection standards to ensure fair and consistent application of prior authorization requirements.
- Potential for reduced administrative burden on healthcare providers through electronic prior authorization.
- Data-driven insights into prior authorization practices through required reports to Congress.
Most Benefited Areas:
Potential Disadvantages
- Potential for increased administrative costs for Medicare Advantage plans to implement the new requirements.
- Possible delays in care if the electronic prior authorization system is not implemented effectively.
- Risk of inconsistent application of enrollee protection standards across different Medicare Advantage plans.
- Complexity of the new regulations may create confusion for both providers and enrollees.
- The effectiveness of the bill depends on the Secretary's rulemaking and enforcement capabilities.
Constitutional Alignment
The bill aligns with the general welfare clause of the Constitution, as it seeks to improve healthcare access for seniors. Congress has the power to legislate on matters related to Social Security and Medicare under its enumerated powers. The bill does not appear to infringe on any specific constitutional rights or limitations.
Impact Assessment: Things You Care About ⓘ
This action has been evaluated across 19 key areas that matter to you. Scores range from 1 (highly disadvantageous) to 5 (highly beneficial).