Improving Seniors’ Timely Access to Care Act of 2025
Key claim: The Improving Seniors’ Timely Access to Care Act of 2025 would require Medicare Advantage plans to implement electronic prior authorization, publicly report approval rates and response times, meet CMS quality and timeliness standards, and support analysis of AI’s impact on patient access.
Abstract
(HR3514 · 119th Congress) Improving Seniors’ Timely Access to Care Act of 2025 This bill establishes several requirements and standards relating to prior authorization processes under Medicare Advantage (MA) plans. Specifically, MA plans must (1) establish an electronic prior authorization program that meets specified standards; (2) annually submit to the CMS for publication specified prior authorization information, including the percentage of requests approved and the average response time; and (3) meet other standards, as set by the Centers for Medicare & Medicaid Services (CMS), relating to the quality and timeliness of prior authorization determinations. The CMS and the Office of the National Coordinator for Health Information Technology must publish on the CMS’ website a report that analyzes the information received from MA plans, the feasibility of implementing real-time decision making with respect to prior authorization requests, and the impact of decisions that are made using artificial intelligence on patient access. Latest action (2026-07-15): Ordered to be Reported in the Nature of a Substitute by the Yeas and Nays: 42 - 0.
Why this matters
Prior authorization is the primary friction point in Medicare Advantage care access, and this bill would move the process from fax- and phone-based workflows to standardized electronic transactions with federally enforced response-time and approval-rate disclosures. If enacted, patients and providers would see published plan-level data on how often and how quickly MA plans approve services, and CMS would gain a formal window into how AI-driven utilization management tools affect access.