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ASTRO applauds new bipartisan legislation to reform prior authorization for Medicare Advantage patients

ARLINGTON, Va., June 12, 2024

The American Society for Radiation Oncology (ASTRO) applauded today’s introduction of bipartisan federal legislation to address critical flaws in the prior authorization process. The Improving Seniors’ Timely Access to Care Act of 2024, introduced by Senators Roger Marshall, MD (R-Kan.), Kyrsten Sinema (I-Ariz.), John Thune (R-S.D.) and Sherrod Brown (D-Ohio) and Representatives Mike Kelly (R-Pa.), Suzan DelBene (D-Wash.), Larry Bucshon, MD (R-Ind.) and Ami Bera, MD (D-Calif.), is an important step toward improving care delivery for people with cancer nationwide.

“The prior authorization system in its current form is ineffective and harmful to patients, creating unnecessary delays to lifesaving cancer treatments and distress for the people who need them. Patients with cancer and their doctors should be the ones making treatment decisions, not insurance companies,” said Jeff M. Michalski, MD, MBA, FASTRO, Chair of the ASTRO Board of Directors.

“This legislation provides a path to make prior authorization for clinically appropriate treatments more efficient and will reduce disruptions in care, bringing much-needed relief from this persistent pain point for physicians and their patients. We applaud the bill’s sponsors for their leadership in making reform a reality for this broken system.”

Radiation oncologists, more than any other clinical specialty, face the greatest likelihood of encountering prior authorization obstacles, according to a 2021 article in JAMA Health Forum. Prior authorization is consistently ranked by radiation oncologists as the biggest challenge facing their clinics. In nationwide surveys by ASTRO, more than 90% of radiation oncologists reported patient treatment delays caused by prior authorization, with the average delay lasting longer than a week. Delays in the start of radiation therapy are associated with worse outcomes for people with cancer, including increased risk of death.

Previous iterations of this legislation amassed overwhelming bipartisan support, including 326 House and 52 Senate cosponsors of the 2021 bill, which passed in the House but not the Senate. Since then, the Centers for Medicare and Medicaid Services (CMS) introduced several new policies that improved prior authorization under Medicare Advantage; the new bill would address unresolved issues, such as establishing a real-time process for coverage decisions.

ASTRO looks forward to working with Hill leaders to pass this important legislation and bring much needed reform to prior authorization for American patients.

The American Society for Radiation Oncology (ASTRO) is the largest radiation oncology society in the world, with more than 10,000 members who are physicians, nurses, biologists, physicists, radiation therapists, dosimetrists and other health care professionals who specialize in treating patients with radiation therapies. Radiation therapy contributes to 40% of global cancer cures, and more than a million Americans receive radiation treatments for cancer each year. For information on radiation therapy, visit RTAnswers.org. To learn more about ASTRO, visit our website and media center and follow us on social media.

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