Improving Seniors’ Timely Access to Care Act of 2025
The source supplies the latest action, but no lifecycle stage.
Latest action (15 Jul 2026): Ordered to be Reported in the Nature of a Substitute by the Yeas and Nays: 42 - 0.
What this bill does
The bill, H.R. 3514, would establish new requirements for Medicare Advantage plans regarding their use of prior authorization. These requirements include implementing an electronic prior authorization system, submitting specified data about prior authorization requests annually to the Centers for Medicare & Medicaid Services (CMS) for publication, and adhering to other standards for timely and quality determinations. The bill also mandates that CMS and the Office of the National Coordinator for Health Information Technology publish a report analyzing this data, exploring real-time decision-making, and assessing the impact of artificial intelligence on patient access.
These changes would affect Medicare Advantage plans and their enrollees. Plans would need to adopt electronic systems and be transparent about their prior authorization processes, including approval rates and response times. Enrollees would benefit from clearer access to criteria used for prior authorization decisions and potentially faster processing times, particularly for routinely approved items and services. The bill aims to improve the efficiency and transparency of the prior authorization process for seniors enrolled in Medicare Advantage.
This bill has been ordered reported by the House Committee on Ways and Means and the Committee on Energy and Commerce. The next step in the legislative process would be for the bill to be considered by the full House of Representatives. If passed by the House, it would then proceed to the Senate for consideration.
Plain-English summary generated by Bill100 AI from the official record. Always verify against the source below.
Official summary
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.
Timeline
15 Jul 2026
Ordered to be Reported in the Nature of a Substitute by the Yeas and Nays: 42 - 0.
Common questions
- What does H.R. 3514 do?
- The bill, H.R. 3514, would establish new requirements for Medicare Advantage plans regarding their use of prior authorization. These requirements include implementing an electronic prior authorization system, submitting specified data about prior authorization requests annually to the Centers for Medicare & Medicaid Services (CMS) for publication, and adhering to other standards for timely and quality determinations. The bill also mandates that CMS and the Office of the National Coordinator for Health Information Technology publish a report analyzing this data, exploring real-time decision-making, and assessing the impact of artificial intelligence on patient access. These changes would affect Medicare Advantage plans and their enrollees. Plans would need to adopt electronic systems and be transparent about their prior authorization processes, including approval rates and response times. Enrollees would benefit from clearer access to criteria used for prior authorization decisions and potentially faster processing times, particularly for routinely approved items and services. The bill aims to improve the efficiency and transparency of the prior authorization process for seniors enrolled in Medicare Advantage. This bill has been ordered reported by the House Committee on Ways and Means and the Committee on Energy and Commerce. The next step in the legislative process would be for the bill to be considered by the full House of Representatives. If passed by the House, it would then proceed to the Senate for consideration.
- Has H.R. 3514 become law?
- The source does not supply a confirmed lifecycle stage for H.R. 3514. Check the latest action and official source below.
- Who sponsored H.R. 3514?
- H.R. 3514 was sponsored by Rep. Kelly, Mike [R-PA-16] (R-PA), with 311 cosponsors.
- What's the latest action on H.R. 3514?
- Ordered to be Reported in the Nature of a Substitute by the Yeas and Nays: 42 - 0. (15 Jul 2026).
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