House · HR 3514 · 119th Congress
Improving Seniors’ Timely Access to Care Act of 2025
Summary
This bill sets new rules for Medicare Advantage insurance plans that require patients to get prior approval before receiving care. Starting in 2027 and 2028, plans must use electronic approval systems, share data on how often they approve or deny requests, and meet new standards to protect patients. Seniors and their doctors are the main people affected.
In Favor
Right now, insurance plans can delay care by taking days to approve or deny treatment requests. This bill requires plans to use faster electronic systems and share data on how often they approve or deny care. Seniors and doctors would get quicker answers and clearer information about why requests are denied.
Against
These new rules require plans to build expensive electronic systems and collect large amounts of data. Complying with those rules costs money, and plans could pass those costs on through higher premiums for seniors. The bill also adds steps to the approval process, which may slow some decisions rather than speed them up.
Additional Considerations
Purpose & Problem
Is the problem real and worth federal action?
This bill requires Medicare Advantage plans to create electronic systems for prior authorization requests. It targets delays in care caused by slow or paper-based approval processes for medical items and services.
Scope & Related Provisions
Does it stay focused, or carry unrelated add-ons?
The bill stays focused on prior authorization in Medicare Advantage plans. It covers electronic programs, data reporting, enrollee protections, and required reports from federal agencies.
Who Is Affected
Who benefits, and who bears the cost?
Medicare Advantage enrollees gain faster decisions and new protections. Doctors and suppliers face new electronic filing rules. Insurance plans must build new systems and report detailed data to federal agencies.
Cost & Funding
Is it affordable and responsibly funded?
The bill does not state a dollar amount or include a cost estimate. It shifts costs onto Medicare Advantage plans to build electronic systems and onto federal agencies to create rules and publish reports.
Risks & Implementation
What could go wrong in practice?
Plans must build electronic systems that meet federal technical standards, which may take time to develop. The bill also requires multiple federal reports by set deadlines, creating a risk of delays if data collection falls behind schedule.
For the actual bill text, see congress.gov.
AI-generated · Published 10/13/2026