Title: Prior Authorization Process Improvement Act
Policy area: Health

Summary:
Prior Authorization Process Improvement Act
This bill requires the Centers for Medicare & Medicaid Services to report on the feasibility of using certain technology to support the administration of Medicare Advantage prior authorization requirements.

[Congressional Bills 115th Congress]
[From the U.S. Government Publishing Office]
[H.R. 7250 Introduced in House (IH)]

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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 
           requirements 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 
consideration 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 Representatives 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''.

SEC. 2. STUDY ON APPLYING CERTAIN TECHNOLOGIES TO THE ADMINISTRATION OF 
              PART C PRIOR AUTHORIZATION 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 described 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;
                    (D) entities advocating on behalf of individuals 
                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 defined 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 suppliers of services and 
        such Medicare Advantage organizations.
            (4) An evaluation of the feasibility of Medicare Advantage 
        organizations and providers and suppliers 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.
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