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Pascrell Backs Senior Medicare Protections

House Ways and Means Committee approved legislation would remove dangerous delays

U.S. Rep. Bill Pascrell, Jr. (D-NJ-09), a senior member of the tax-writing House Ways and Means Committee, today supported advancing H.R. 8487, the Improving Seniors’ Timely Access to Care Act, sending it to the full House for consideration.

“American seniors need more barriers to their health care like they need a shingles diagnosis,” said Rep. Pascrell. “Unnecessary delays in the Medicare Advantage (MA) program endanger Americans’ health and waste doctors’ valuable time.  The health of every single Medicare patient should be determined by need, not some executive’s profit margin. Our bill requires more transparency and crucially will provide a faster and clearer approval process for MA beneficiaries. Our committee has acted swiftly and now the full House should do the same to protect Medicare.”

Traditional Medicare rarely requires prior authorization for services. Conversely, private MA plans can demand prior approval for any service. The intent of prior authorization is to deter patients from unnecessary care. Yet, all too often MA plans delay or deny access to services that clearly meet coverage requirements.

The Health and Human Services Inspector General recently found that MA plans inappropriately deny care at very high rates. MA plans routinely overbill Medicare, generating an estimated $6 Billion a year in excess payments.

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