The American College of Surgeons (ACS) has long supported policies that improve surgical patient care, lessen administrative burdens, and streamline clinical workflow. To combat policies that could further overburden surgeons and their practices, the ACS supports specific regulatory and legislative actions to eliminate unnecessary requirements that may hinder timely access to surgical care.
Surgical patients are encountering barriers to timely access care due to onerous and unnecessary prior authorization (PA) requests from Medicare Advantage (MA) plans and commercial insurers. Utilization review tools such as PA can sometimes play a role in ensuring patients receive clinically appropriate treatment while controlling costs. However, the ACS is concerned about the growing administrative burdens and the delays in medically necessary care associated with excessive PA requirements.
The ACS has joined with the Regulatory Relief Coalition, a coalition of specialty provider organizations, in working with key members of Congress on bipartisan legislation to improve transparency and efficiency of the PA process in the MA program. In order to improve continuity of care, the ACS continues to support the Improving Seniors’ Timely Access to Care Act, which would facilitate electronic prior authorization, improve transparency, and increase Centers for Medicare & Medicaid Services (CMS) oversight on how MA plans apply PA requirements.