I 
115TH CONGRESS 
2D SESSION 
H. R. 7250 
To direct the Secretary of Health and Human Services to conduct a study 
and submit to Congress a report on the feasibility of using certain 
technologies to facilitate the administration of prior authorization require-
ments under part C of the Medicare program. 
IN THE HOUSE OF REPRESENTATIVES 
DECEMBER 11, 2018 
Mr. KELLY of Pennsylvania (for himself and Mr. GUTHRIE) introduced the 
following bill; which was referred to the Committee on Ways and Means, 
and in addition to the Committee on Energy and Commerce, for a period 
to be subsequently determined by the Speaker, in each case for consider-
ation of such provisions as fall within the jurisdiction of the committee 
concerned 
A BILL 
To direct the Secretary of Health and Human Services to 
conduct a study and submit to Congress a report on 
the feasibility of using certain technologies to facilitate 
the administration of prior authorization requirements 
under part C of the Medicare program. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Prior Authorization 
Process Improvement Act’’. 
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SEC. 2. STUDY ON APPLYING CERTAIN TECHNOLOGIES TO 
THE ADMINISTRATION OF PART C PRIOR AU-
THORIZATION REQUIREMENTS UNDER THE 
MEDICARE PROGRAM. 
(a) IN GENERAL.—Not later than 12 months after 
the date of the enactment of this Act, the Secretary of 
Health and Human Services (in this section referred to 
as the ‘‘Secretary’’) shall conduct a study and submit to 
Congress a report on the feasibility of Medicare Advantage 
organizations and providers and suppliers of services (as 
defined in section 1861 of the Social Security Act (42 
U.S.C. 1395x)) using certain technologies to facilitate the 
administration of prior authorization requirements under 
Medicare Advantage plans offered by such organizations 
under part C of title XVIII of the Social Security Act (42 
U.S.C. 1395w–21 et seq.). 
(b) ADVISORY PANEL.— 
(1) IN GENERAL.—In conducting the study de-
scribed in subsection (a), the Secretary shall consult 
with an advisory panel convened by the Secretary. 
(2) SELECTION.—The Secretary shall select 
members of the panel convened under paragraph 
(1). Such members shall include representatives of— 
(A) Medicare Advantage organizations; 
(B) providers and suppliers of services; 
(C) technology vendors; 
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(D) entities advocating on behalf of indi-
viduals entitled to benefits under part A of title 
XVIII of the Social Security Act (42 U.S.C. 
1395c et seq.) or enrolled under part B of such 
title of such Act (42 U.S.C. 1395j et seq.); and 
(E) standard setting organizations (as de-
fined in section 1171(8) of such Act (42 U.S.C. 
1320d–1(8))). 
(c) REPORT CONTENTS.—The report described in 
subsection (a) shall include the following: 
(1) A description of existing technologies that 
may be used to facilitate the administration of prior 
authorization requirements under part C of title 
XVIII of the Social Security Act. 
(2) An evaluation of the utilization of such 
technologies by providers and suppliers of services 
and Medicare Advantage organizations with respect 
to individuals described in subsection (b)(2)(D) or 
not described in such subsection. 
(3) A cost-benefit analysis with respect to the 
use of such technologies by such providers and sup-
pliers of services and such Medicare Advantage orga-
nizations. 
(4) An evaluation of the feasibility of Medicare 
Advantage organizations and providers and suppliers 
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of services potentially using such technologies under 
part C of the Medicare program. 
(5) Recommendations on how to improve the 
administration of such requirements through the use 
of technology. 
Æ 
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