S1816119th CongressWALLET

Improving Seniors’ Timely Access to Care Act of 2025

Sponsored By: Senator Marshall, Roger [R-KS]

Introduced

Summary

This bill would force Medicare Advantage plans to adopt a standardized, electronic prior authorization system and publish detailed approval and denial data to speed patient access and enable oversight. It sets deadlines for transparency and electronic processing and creates reporting and real-time decision rules to shrink delays and reveal how plans use automation.

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Bill Overview

Analyzed Economic Effects

2 provisions identified: 2 benefits, 0 costs, 0 mixed.

Electronic prior authorization for Medicare

If enacted, Medicare Advantage plans that use prior authorization would need an electronic prior authorization system starting with plan years that begin on or after January 1, 2028. Plans would have to send requests, responses, and supporting documents electronically and follow technical standards. The bill would also require yearly plan-level reports starting with plan years that begin on or after January 1, 2027. Reports would list items that need authorization, approval and denial rates, appeal outcomes, timing data, and what technologies (for example, AI) were used. CMS would publish these data by plan. The rule would not cover Part D drugs and faxes or noncompliant portals would not count as the required electronic transmission.

Faster prior authorization rules for Medicare

If enacted, the bill would require Medicare Advantage plans to meet new prior authorization protection standards starting with plan years that begin on or after January 1, 2028. Plans would need to design transparent programs with enrollee and provider input, allow waivers or changes for trusted high-performing providers, and review authorization lists each year. The Secretary could set firm deadlines for plan responses, including shorter timeframes (for example, 24 hours) for some requests. A modified 72-hour expedited rule would apply to requests filed on or after the first day of the third plan year after enactment.

Sponsors & CoSponsors

Sponsor

Marshall, Roger [R-KS]

KS • R

Cosponsors

  • Sen. Hirono, Mazie K. [D-HI]

    HI • D

    Sponsored 5/20/2025

  • Sen. Warner, Mark R. [D-VA]

    VA • D

    Sponsored 5/20/2025

  • Sen. Hassan, Margaret Wood [D-NH]

    NH • D

    Sponsored 5/20/2025

  • Sen. Fetterman, John [D-PA]

    PA • D

    Sponsored 5/20/2025

  • Amy Klobuchar

    MN • D

    Sponsored 5/20/2025

  • Sen. Cassidy, Bill [R-LA]

    LA • R

    Sponsored 5/20/2025

  • Shelley Capito

    WV • R

    Sponsored 5/20/2025

  • John Hickenlooper

    CO • D

    Sponsored 5/20/2025

  • Sen. Lankford, James [R-OK]

    OK • R

    Sponsored 5/20/2025

  • Sen. Merkley, Jeff [D-OR]

    OR • D

    Sponsored 5/20/2025

  • Sen. Blackburn, Marsha [R-TN]

    TN • R

    Sponsored 5/20/2025

  • Sen. Lummis, Cynthia M. [R-WY]

    WY • R

    Sponsored 5/20/2025

  • Cindy Hyde-Smith

    MS • R

    Sponsored 5/20/2025

  • Sen. Kaine, Tim [D-VA]

    VA • D

    Sponsored 5/20/2025

  • Sen. Shaheen, Jeanne [D-NH]

    NH • D

    Sponsored 5/20/2025

  • Mike Rounds

    SD • R

    Sponsored 5/20/2025

  • Sen. Padilla, Alex [D-CA]

    CA • D

    Sponsored 5/20/2025

  • Bill Hagerty

    TN • R

    Sponsored 5/20/2025

  • Sen. Kim, Andy [D-NJ]

    NJ • D

    Sponsored 5/20/2025

  • John Boozman

    AR • R

    Sponsored 5/20/2025

  • Sen. Durbin, Richard J. [D-IL]

    IL • D

    Sponsored 5/20/2025

  • Sen. Cornyn, John [R-TX]

    TX • R

    Sponsored 5/20/2025

  • Sen. Murray, Patty [D-WA]

    WA • D

    Sponsored 5/20/2025

  • Sen. Moran, Jerry [R-KS]

    KS • R

    Sponsored 5/20/2025

  • Sen. Gillibrand, Kirsten E. [D-NY]

    NY • D

    Sponsored 5/20/2025

  • Sen. Cantwell, Maria [D-WA]

    WA • D

    Sponsored 5/20/2025

  • Sen. Tillis, Thomas [R-NC]

    NC • R

    Sponsored 5/20/2025

  • Sen. Booker, Cory A. [D-NJ]

    NJ • D

    Sponsored 5/20/2025

  • Sen. Smith, Tina [D-MN]

    MN • D

    Sponsored 5/20/2025

  • Peter Welch

    VT • D

    Sponsored 5/20/2025

  • Sen. Whitehouse, Sheldon [D-RI]

    RI • D

    Sponsored 5/20/2025

  • Sen. Budd, Ted [R-NC]

    NC • R

    Sponsored 5/20/2025

  • Sen. Cortez Masto, Catherine [D-NV]

    NV • D

    Sponsored 5/20/2025

  • Sen. Sheehy, Tim [R-MT]

    MT • R

    Sponsored 5/20/2025

  • Sen. Baldwin, Tammy [D-WI]

    WI • D

    Sponsored 5/20/2025

  • Sen. Ricketts, Pete [R-NE]

    NE • R

    Sponsored 5/20/2025

  • Sen. Blumenthal, Richard [D-CT]

    CT • D

    Sponsored 5/20/2025

  • Sen. Warren, Elizabeth [D-MA]

    MA • D

    Sponsored 5/20/2025

  • Sen. Duckworth, Tammy [D-IL]

    IL • D

    Sponsored 5/20/2025

  • John Hoeven

    ND • R

    Sponsored 5/20/2025

  • Sen. Scott, Rick [R-FL]

    FL • R

    Sponsored 5/20/2025

  • Sen. Kelly, Mark [D-AZ]

    AZ • D

    Sponsored 5/20/2025

  • Sen. Rosen, Jacky [D-NV]

    NV • D

    Sponsored 5/20/2025

  • Sen. Heinrich, Martin [D-NM]

    NM • D

    Sponsored 5/20/2025

  • Sen. Fischer, Deb [R-NE]

    NE • R

    Sponsored 5/20/2025

  • Sen. Coons, Christopher A. [D-DE]

    DE • D

    Sponsored 5/20/2025

  • Sen. Hawley, Josh [R-MO]

    MO • R

    Sponsored 5/20/2025

  • Sen. Collins, Susan M. [R-ME]

    ME • R

    Sponsored 6/3/2025

  • Raphael Warnock

    GA • D

    Sponsored 6/3/2025

  • Sen. Gallego, Ruben [D-AZ]

    AZ • D

    Sponsored 6/3/2025

  • Markwayne Mullin

    OK • R

    Sponsored 6/9/2025

  • Sen. Banks, Jim [R-IN]

    IN • R

    Sponsored 7/14/2025

  • Gary Peters

    MI • D

    Sponsored 7/21/2025

  • Sen. Cramer, Kevin [R-ND]

    ND • R

    Sponsored 9/2/2025

  • Sen. Schiff, Adam B. [D-CA]

    CA • D

    Sponsored 9/2/2025

  • Sen. Bennet, Michael F. [D-CO]

    CO • D

    Sponsored 9/3/2025

  • Sen. Schmitt, Eric [R-MO]

    MO • R

    Sponsored 9/17/2025

  • Sen. Moreno, Bernie [R-OH]

    OH • R

    Sponsored 9/18/2025

  • Sen. Justice, James C. [R-WV]

    WV • R

    Sponsored 9/18/2025

  • Sen. Luján, Ben Ray [D-NM]

    NM • D

    Sponsored 9/30/2025

  • Sen. Ernst, Joni [R-IA]

    IA • R

    Sponsored 10/7/2025

  • Sen. Kennedy, John [R-LA]

    LA • R

    Sponsored 10/21/2025

  • Sen. Husted, Jon [R-OH]

    OH • R

    Sponsored 10/21/2025

  • Elissa Slotkin

    MI • D

    Sponsored 12/17/2025

  • Sen. Van Hollen, Chris [D-MD]

    MD • D

    Sponsored 2/10/2026

  • Sen. Moody, Ashley [R-FL]

    FL • R

    Sponsored 2/12/2026

  • Sen. McCormick, David [R-PA]

    PA • R

    Sponsored 3/17/2026

  • Sen. Tuberville, Tommy [R-AL]

    AL • R

    Sponsored 4/27/2026

  • Sen. King, Angus S., Jr. [I-ME]

    ME • I

    Sponsored 5/11/2026

  • Sen. Blunt Rochester, Lisa [D-DE]

    DE • D

    Sponsored 5/12/2026

Roll Call Votes

No roll call votes available for this bill.

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