Bill · S. 3762· Senate(119-S-3762)
Prior Authorization Relief Act
- Introduced
- 2/3/2026
- Last activity
- 2/3/2026 — Read twice and referred to the Committee on Finance.
- Sponsored by
- Sheldon Whitehouse
- Cosponsors
- - 0 - 1
- Introduced
- In Committee
What this bill would do
This bill, titled the ``Prior Authorization Relief Act'', aims to reform prior authorization within the Medicare Advantage program. It directs the Secretary to conduct an audit of items, services, and covered part D drugs that meet specific criteria, such as high reimbursement rates or excessive protocol steps. Following this audit, the Secretary must create a final rule to standardize prior authorization requirements across all Medicare Advantage plans. The bill also includes provisions for exemptions for certain providers operating under specific risk models.
Yes· 3 of 5
Would people over 65 be better off under this?+5
The bill aims to simplify access to medical services and drugs for Medicare Advantage enrollees through standardized prior authorization.
Would retired people be better off under this?+5
Standardizing the prior authorization process can reduce delays and complexity for retirees enrolled in Medicare Advantage plans.
Does this make health care easier to get in general?+5
Standardizing prior authorization requirements is intended to reduce the administrative burden and excessive steps required to access services and drugs.
The opposite
No question was scored the opposite.
Who it would affect, and how
Potential Positive Impacts for People
-
Standardized requirements: The bill requires the Secretary to standardize prior authorization requirements and supplemental forms for specific items, services, and drugs (Section 2, subsection (a)(2)). This could create more consistency for enrollees across different Medicare Advantage plans.
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Identification of problematic processes: The Secretary is tasked with auditing requirements to find those that involve an excessive number of steps to complete required protocols (Section 2, subsection (a)(1)(C)). This process identifies specific items or services that may be causing undue difficulty for patients.
Potential Negative Impacts for People
- Exemptions from standardized requirements: Certain providers participating in two-sided risk models may be exempt from the new standardized prior authorization requirements (Section 2, subsection (a)(3)(A)). Additionally, Medicare Advantage organizations can request that these exemptions not apply, allowing their existing prior authorization requirements to continue (Section 2, subsection (a)(3)(B)).
Groups and Interests Ranking
Every group the model scored this bill for, from -10 to +10. Hover a score for the reason it gave.
- Demographic And Interest Groups
- Good For Retirees+5Good For Seniors+5
- Healthcare
- Improves Healthcare Access+5Increases Medicare Funding+3Reduces Prescription Drug Costs+2
- 4/13/2026
- 1 Cosponsor added.
- 2/3/2026
- Read twice and referred to the Committee on Finance.
- Introduced in Senate
Roger MarshallRepublican · Kansas