S1816119th CongressWALLET

Improving Seniors’ Timely Access to Care Act of 2025

Sponsored By: Senator Roger Marshall

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.

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

Roger Marshall

KS • R

Cosponsors

  • Mazie Hirono

    HI • D

    Sponsored 5/20/2025

  • Mark Warner

    VA • D

    Sponsored 5/20/2025

  • Maggie Hassan

    NH • D

    Sponsored 5/20/2025

  • John Fetterman

    PA • D

    Sponsored 5/20/2025

  • Amy Klobuchar

    MN • D

    Sponsored 5/20/2025

  • Bill Cassidy

    LA • R

    Sponsored 5/20/2025

  • Shelley Capito

    WV • R

    Sponsored 5/20/2025

  • John Hickenlooper

    CO • D

    Sponsored 5/20/2025

  • James Lankford

    OK • R

    Sponsored 5/20/2025

  • Jeff Merkley

    OR • D

    Sponsored 5/20/2025

  • Marsha Blackburn

    TN • R

    Sponsored 5/20/2025

  • Cynthia Lummis

    WY • R

    Sponsored 5/20/2025

  • Cindy Hyde-Smith

    MS • R

    Sponsored 5/20/2025

  • Timothy Kaine

    VA • D

    Sponsored 5/20/2025

  • Jeanne Shaheen

    NH • D

    Sponsored 5/20/2025

  • Mike Rounds

    SD • R

    Sponsored 5/20/2025

  • Alex Padilla

    CA • D

    Sponsored 5/20/2025

  • Bill Hagerty

    TN • R

    Sponsored 5/20/2025

  • Andy Kim

    NJ • D

    Sponsored 5/20/2025

  • John Boozman

    AR • R

    Sponsored 5/20/2025

  • Richard Durbin

    IL • D

    Sponsored 5/20/2025

  • John Cornyn

    TX • R

    Sponsored 5/20/2025

  • Patty Murray

    WA • D

    Sponsored 5/20/2025

  • Jerry Moran

    KS • R

    Sponsored 5/20/2025

  • Kirsten Gillibrand

    NY • D

    Sponsored 5/20/2025

  • Maria Cantwell

    WA • D

    Sponsored 5/20/2025

  • Thomas Tillis

    NC • R

    Sponsored 5/20/2025

  • Cory Booker

    NJ • D

    Sponsored 5/20/2025

  • Tina Smith

    MN • D

    Sponsored 5/20/2025

  • Peter Welch

    VT • D

    Sponsored 5/20/2025

  • Sheldon Whitehouse

    RI • D

    Sponsored 5/20/2025

  • Ted Budd

    NC • R

    Sponsored 5/20/2025

  • Catherine Cortez Masto

    NV • D

    Sponsored 5/20/2025

  • Tim Sheehy

    MT • R

    Sponsored 5/20/2025

  • Tammy Baldwin

    WI • D

    Sponsored 5/20/2025

  • Pete Ricketts

    NE • R

    Sponsored 5/20/2025

  • Richard Blumenthal

    CT • D

    Sponsored 5/20/2025

  • Elizabeth Warren

    MA • D

    Sponsored 5/20/2025

  • Tammy Duckworth

    IL • D

    Sponsored 5/20/2025

  • John Hoeven

    ND • R

    Sponsored 5/20/2025

  • Rick Scott

    FL • R

    Sponsored 5/20/2025

  • Mark Kelly

    AZ • D

    Sponsored 5/20/2025

  • Jacky Rosen

    NV • D

    Sponsored 5/20/2025

  • Martin Heinrich

    NM • D

    Sponsored 5/20/2025

  • Deb Fischer

    NE • R

    Sponsored 5/20/2025

  • Christopher Coons

    DE • D

    Sponsored 5/20/2025

  • Josh Hawley

    MO • R

    Sponsored 5/20/2025

  • Susan Collins

    ME • R

    Sponsored 6/3/2025

  • Raphael Warnock

    GA • D

    Sponsored 6/3/2025

  • Ruben Gallego

    AZ • D

    Sponsored 6/3/2025

  • Markwayne Mullin

    OK • R

    Sponsored 6/9/2025

  • Jim Banks

    IN • R

    Sponsored 7/14/2025

  • Gary Peters

    MI • D

    Sponsored 7/21/2025

  • Kevin Cramer

    ND • R

    Sponsored 9/2/2025

  • Adam Schiff

    CA • D

    Sponsored 9/2/2025

  • Michael Bennet

    CO • D

    Sponsored 9/3/2025

  • Eric Schmitt

    MO • R

    Sponsored 9/17/2025

  • Bernie Moreno

    OH • R

    Sponsored 9/18/2025

  • James Justice

    WV • R

    Sponsored 9/18/2025

  • Sen. Luján, Ben Ray [D-NM]

    NM • D

    Sponsored 9/30/2025

  • Joni Ernst

    IA • R

    Sponsored 10/7/2025

  • John Kennedy

    LA • R

    Sponsored 10/21/2025

  • Jon Husted

    OH • R

    Sponsored 10/21/2025

  • Elissa Slotkin

    MI • D

    Sponsored 12/17/2025

  • Chris Van Hollen

    MD • D

    Sponsored 2/10/2026

Roll Call Votes

No roll call votes available for this bill.

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