Search Results: keywords:"prior authorization"

  • S. 3832 — To amend title XVIII of the Social Security Act to ensure appropriate access to non-opioid pain management drugs under part D of the Medicare program.
    Status:Introduced in Senate
    Words:1,203

    The bill, S. 3832, known as the "Alternatives to PAIN Act," aims to amend the Social Security Act to improve access to non-opioid pain management drugs under Medicare Part D. Starting in 2025, it requires these drugs to avoid deductibles and to be placed on the lowest cost-sharing tier. It...

    Simple Explanation

    The bill wants to make it easier for people on Medicare to get non-opioid medicines for pain, without extra costs or jumping through hoops, starting in 2025. This means they can choose certain pain medicines that aren't based on opioids, like pills you take if you have a headache, without needing to try stronger drugs first.

  • S. 4532 — To amend title XVIII of the Social Security Act to establish requirements with respect to the use of prior authorization under Medicare Advantage plans.
    Status:Introduced in Senate
    Words:2,925

    S. 4532 aims to amend the Social Security Act to set rules about how Medicare Advantage plans use prior authorization for covering services. It mandates that by 2027, Medicare Advantage plans must have an electronic prior authorization system and meet protection standards for...

    Simple Explanation

    S. 4532 is a bill that wants to make sure health plans for older people, called Medicare Advantage, have fair and easy rules when deciding if they'll pay for a doctor's service in the future, using computers to help. By 2027, these plans have to be quick and clear about their decisions and tell people when they say yes or no to paying for a service.

  • H. R. 8702 — To amend title XVIII of the Social Security Act to establish requirements with respect to the use of prior authorization under Medicare Advantage plans.
    Status:Introduced in House
    Words:3,363

    H.R. 8702 aims to modify the Social Security Act to regulate prior authorization processes in Medicare Advantage plans. Starting in 2026, the bill requires these plans to meet specific transparency and electronic authorization standards by 2027. It includes provisions for...

    Simple Explanation

    Think of H.R. 8702 like a rule that makes sure when Grandma needs something called "Medicare Advantage" to help her see a doctor, everything happens quickly and clearly. By 2027, doctors and helpers need to use computers to talk to each other instead of sending papers, so Grandma doesn't wait too long for her care.

  • H. R. 7142 — To amend title XVIII of the Social Security Act to ensure appropriate access to non-opioid pain management drugs under part D of the Medicare program.
    Status:Introduced in House
    Words:1,809

    H.R. 7142 aims to improve access to non-opioid pain management drugs for Medicare part D enrollees by removing cost-sharing barriers. It ensures these drugs are placed on the lowest cost-sharing tier and exempt from deductibles, starting January 1, 2025. The bill prohibits...

    Simple Explanation

    H.R. 7142 is a plan to make it easier for older people on Medicare to get medicine for pain that isn't from opioids, by making these medicines cheaper and removing some rules, starting in 2025.

  • S. 4349 — To require private health plans to provide for secure electronic transmission of prior authorization requests for prescription drugs.
    Status:Introduced in Senate
    Words:1,365

    S. 4349 requires private health plans to electronically handle requests for prior authorization of prescription drugs through secure means. Starting in 2027, health plans must ensure these transactions meet specific technical standards set by authorities like the Secretary of Health and Human...

    Simple Explanation

    This bill wants to make sure that when doctors ask health insurance companies if it's okay to give someone certain medicine, they do it using computers in a safe way, not by sending paper or fax. Starting in 2027, they have to use special rules to keep everything secure and quick, so everyone works together smoothly.

  • S. 4518 — To amend title XVIII of the Social Security Act to establish requirements with respect to the use of prior authorization under Medicare Advantage plans.
    Status:Introduced in Senate
    Words:2,770

    The bill S. 4518 seeks to amend the Social Security Act to set new rules for prior authorization under Medicare Advantage plans. It aims to establish an electronic system for handling prior authorization requests and enforce transparency by requiring plans to report various...

    Simple Explanation

    The bill wants to make it easier for older people to get the healthcare they need by using computers and new technology to decide quickly if their medical treatments are approved, and by being open about how these decisions are made.