{"check":null,"uid":"caa408abe0f1a846","title":"Improving Seniors’ Timely Access to Care Act of 2025","title_generated":false,"country":"США","organ":"Конгресс США","kind":"law","kind_name":"Законодательство","lang":"en","date":"2026-07-29","summary":"Планы Medicare Advantage, требующие предварительного согласования услуг (prior authorization), с планового года после 1 января 2028 года обмениваются запросами и ответами с врачами только электронно: факс и не отвечающий стандартам портал страховщика не в счёт. С 1 января 2027 года они ежегодно раскрывают перечень услуг под согласованием, доли одобрений, отказов и обжалований, средний и медианный срок ответа в часах и отдельно — долю решений, принятых с помощью искусственного интеллекта, машинного обучения и систем поддержки решений, с описанием технологии. CMS публикует данные по каждому плану, министр вправе задать срок ответа, например 24 часа; GAO оценит исполнение к 1 января 2032 года.","snippet":"","topics":["Искусственный интеллект"],"status":"ok","error":"","text_len":16997,"versions":1,"url":"https://www.congress.gov/bill/119-congress/hr/3514","first_seen":"2026-08-19","last_checked":"2026-09-17 01:57","relevance":"hit","score":10,"query":"","source_key":"congress_us","verdict":{"relevance":"hit","score":10,"topics":["Искусственный интеллект"],"need_body":3,"authorities":[],"evidence":[{"topic":"Искусственный интеллект","term":"искусственн","weak":false,"pos":519,"ctx":"ий, средний и медианный срок ответа в часах и отдельно — долю решений, принятых с помощью искусственного интеллекта, машинного обучения и систем поддержки решений, с описанием технологии. cms пу","zone":"название","weight":3},{"topic":"Искусственный интеллект","term":"машинн обучен","weak":false,"pos":546,"ctx":"к ответа в часах и отдельно — долю решений, принятых с помощью искусственного интеллекта, машинного обучения и систем поддержки решений, с описанием технологии. cms публикует данные по каждому плану","zone":"название","weight":3},{"topic":"Искусственный интеллект","term":"artificial intelligence","weak":false,"pos":983,"ctx":"respect to prior authorization requests, and the impact of decisions that are made using artificial intelligence on patient access.  full text [congressional bills 119th congress] [from the u.s. governm","zone":"текст","weight":1},{"topic":"Искусственный интеллект","term":"artificial intelligence","weak":false,"pos":7083,"ctx":"lan during the previous plan year through the utilization of decision support technology, artificial intelligence technology, machine- learning technology, clinical decision- making technology, or any ot","zone":"текст","weight":1},{"topic":"Искусственный интеллект","term":"machine learning","weak":false,"pos":7119,"ctx":"rough the utilization of decision support technology, artificial intelligence technology, machine- learning technology, clinical decision- making technology, or any other technology specified by th","zone":"текст","weight":1},{"topic":"Искусственный интеллект","term":"artificial intelligence","weak":false,"pos":15467,"ctx":"eterminations of routinely approved items and services made solely through automation and artificial intelligence by medicare advantage plans impact patient access, including disparities in access for ru","zone":"текст","weight":1}],"dropped":[]},"last_changed":"2026-08-19","meta":{"congress":"119","billType":"HR","number":"3514","policyArea":"Health","subjects":["Administrative law and regulatory procedures","Computers and information technology","Congressional oversight","Department of Health and Human Services","Government information and archives","Health care coverage and access","Internet, web applications, social media","Medicare"],"latestAction":"2025-05-20 Read twice and referred to the Committee on Finance."},"source_url":"https://www.congress.gov/bill/119-congress/hr/3514","text":"SUMMARY\nImproving Seniors' Timely Access to Care Act of 2025\nThis bill establishes several requirements and standards relating to prior authorization processes under Medicare Advantage (MA) plans.\nSpecifically, MA plans must (1) establish an electronic prior authorization program that meets specified standards; (2) annually submit to the CMS for publication specified prior authorization information, including the percentage of requests approved and the average response time; and (3) meet other standards, as set by the Centers for Medicare & Medicaid Services (CMS), relating to the quality and timeliness of prior authorization determinations.\nThe CMS and the Office of the National Coordinator for Health Information Technology must publish on the CMS' website a report that analyzes the information received from MA plans, the feasibility of implementing real-time decision making with respect to prior authorization requests, and the impact of decisions that are made using artificial intelligence on patient access.\n\nFULL TEXT\n[Congressional Bills 119th Congress]\n[From the U.S. Government Publishing Office]\n[H.R. 3514 Introduced in House (IH)]\n\n<DOC>\n\n119th CONGRESS\n1st Session\nH. R. 3514\n\nTo amend title XVIII of the Social Security Act to establish\nrequirements with respect to the use of prior authorization under\nMedicare Advantage plans.\n\n_______________________________________________________________________\n\nIN THE HOUSE OF REPRESENTATIVES\n\nMay 20, 2025\n\nMr. Kelly of Pennsylvania (for himself, Ms. DelBene, Mr. Joyce of\nPennsylvania, Mr. Bera, Ms. Van Duyne, Ms. Chu, Mr. Crenshaw, Ms.\nClarke of New York, Mr. Murphy, Ms. Moore of Wisconsin, Mr. Balderson,\nMs. Schrier, Mr. Yakym, Ms. Sewell, Mrs. Harshbarger, Mr. Larson of\nConnecticut, Mr. Carey, Mr. Evans of Pennsylvania, Ms. Malliotakis, Mr.\nBeyer, Ms. Tenney, Ms. Tokuda, Mrs. Miller of West Virginia, Ms.\nStevens, Mr. Fitzpatrick, Mr. Costa, Mr. Smucker, Ms. Pressley, Mr.\nLaHood, Mr. Davis of North Carolina, Mr. Meuser, Mr. Pocan, Ms.\nSalazar, Mr. Fields, Mr. Bacon, Mr. Foster, Mr. Mann, Ms. Brownley, Mr.\nCiscomani, Mr. Conaway, Mr. Finstad, Ms. Bonamici, Mr. Shreve, Ms.\nNorton, Mrs. Kiggans of Virginia, Mr. Deluzio, Mr. Thompson of\nPennsylvania, Mr. Mrvan, Mr. Moulton, Mr. Case, Ms. McBride, Ms. Ross,\nMs. Budzinski, Mr. Quigley, Mr. Sorensen, Mr. McGarvey, Ms. Davids of\nKansas, Ms. Brown, Mr. Crow, Mr. Torres of New York, Ms. Wasserman\nSchultz, Mr. Stanton, Mr. Levin, Mr. Keating, Ms. Johnson of Texas, Mr.\nVicente Gonzalez of Texas, Ms. Goodlander, Ms. Craig, Mr. Goldman of\nNew York, Ms. Barragan, Ms. Balint, Mr. Ryan, Ms. Houlahan, and Mrs.\nMiller-Meeks) introduced the following bill; which was referred to the\nCommittee on Ways and Means, and in addition to the Committee on Energy\nand Commerce, for a period to be subsequently determined by the\nSpeaker, in each case for consideration of such provisions as fall\nwithin the jurisdiction of the committee concerned\n\n_______________________________________________________________________\n\nA BILL\n\nTo amend title XVIII of the Social Security Act to establish\nrequirements with respect to the use of prior authorization under\nMedicare Advantage plans.\n\nBe it enacted by the Senate and House of Representatives of the\nUnited States of America in Congress assembled,\n\nSECTION 1. SHORT TITLE.\n\nThis Act may be cited as the ``Improving Seniors' Timely Access to\nCare Act of 2025''.\n\nSEC. 2. ESTABLISHING REQUIREMENTS WITH RESPECT TO THE USE OF PRIOR\nAUTHORIZATION UNDER MEDICARE ADVANTAGE PLANS.\n\n(a) In General.--Section 1852 of the Social Security Act (42 U.S.C.\n1395w-22) is amended by adding at the end the following new subsection:\n``(o) Prior Authorization Requirements.--\n``(1) In general.--In the case of a Medicare Advantage plan\nthat imposes any prior authorization requirement with respect\nto any applicable item or service (as defined in paragraph (5))\nduring a plan year, such plan shall--\n``(A) beginning with plan years beginning on or\nafter January 1, 2028--\n``(i) establish the electronic prior\nauthorization program described in paragraph\n(2); and\n``(ii) meet the enrollee protection\nstandards specified pursuant to paragraph (4);\nand\n``(B) beginning with plan years beginning on or\nafter January 1, 2027, meet the transparency\nrequirements specified in paragraph (3).\n``(2) Electronic prior authorization program.--\n``(A) In general.--For purposes of paragraph\n(1)(A), the electronic prior authorization program\ndescribed in this paragraph is a program that provides\nfor the secure electronic transmission of--\n``(i) a prior authorization request from a\nprovider or supplier to a Medicare Advantage\nplan with respect to an applicable item or\nservice to be furnished to an individual and a\nresponse, in accordance with this paragraph,\nfrom such plan to such provider or supplier;\nand\n``(ii) any supporting documentation\nrelating to such request or response.\n``(B) Electronic transmission.--\n``(i) Exclusions.--For purposes of this\nparagraph, a facsimile, a proprietary payer\nportal that does not meet standards specified\nby the Secretary, or an electronic form shall\nnot be treated as an electronic transmission\ndescribed in subparagraph (A).\n``(ii) Standards.--An electronic\ntransmission described in subparagraph (A)\nshall comply with applicable technical\nstandards and other requirements to promote the\nstandardization and streamlining of electronic\ntransactions adopted by the Secretary.\n``(3) Transparency requirements.--\n``(A) In general.--For purposes of paragraph\n(1)(B), the transparency requirements specified in this\nparagraph are, with respect to a Medicare Advantage\nplan, the following:\n``(i) The plan, annually and in a manner\nspecified by the Secretary, shall submit to the\nSecretary the following information:\n``(I) A list of all applicable\nitems and services that were subject to\na prior authorization requirement under\nthe plan during the previous plan year.\n``(II) The percentage and number of\nspecified requests (as defined in\nsubparagraph (F)) approved during the\nprevious plan year by the plan in an\ninitial determination and the\npercentage and number of specified\nrequests denied during such plan year\nby such plan in an initial\ndetermination (both in the aggregate\nand categorized by each item and\nservice).\n``(III) The percentage and number\nof specified requests that were denied\nduring the previous plan year by the\nplan in an initial determination and\nthat were subsequently appealed.\n``(IV) The number of appeals of\nspecified requests resolved during the\npreceding plan year, and the percentage\nand number of such resolved appeals\nthat resulted in approval of the\nfurnishing of the item or service that\nwas the subject of such request,\ncategorized by each applicable item and\nservice and categorized by each level\nof appeal (including judicial review).\n``(V) The percentage and number of\nspecified requests that were denied,\nand the percentage and number of\nspecified requests that were approved,\nby the plan during the previous plan\nyear through the utilization of\ndecision support technology, artificial\nintelligence technology, machine-\nlearning technology, clinical decision-\nmaking technology, or any other\ntechnology specified by the Secretary.\n``(VI) The average and the median\namount of time (in hours) that elapsed\nduring the previous plan year between\nthe submission of a specified request\nto the plan and a determination by the\nplan with respect to such request for\neach such item and service, excluding\nany such requests that were not\nsubmitted with the medical or other\ndocumentation required to be submitted\nby the plan.\n``(VII) The percentage and number\nof specified requests that were\nexcluded from the calculation described\nin subclause (VI) based on the plan's\ndetermination that such requests were\nnot submitted with the medical or other\ndocumentation required to be submitted\nby the plan.\n``(VIII) Information on each\noccurrence during the previous plan\nyear in which, during a surgical or\nmedical procedure involving the\nfurnishing of an applicable item or\nservice with respect to which such plan\nhad approved a prior authorization\nrequest, the provider or supplier\nfurnishing such item or service\ndetermined that a different or\nadditional item or service was\nmedically necessary, including a\nspecification of whether such plan\nsubsequently approved the furnishing of\nsuch different or additional item or\nservice.\n``(IX) A disclosure and description\nof any technology described in\nsubclause (V) that the plan utilized\nduring the previous plan year in making\ndeterminations with respect to\nspecified requests.\n``(X) The number of grievances (as\ndescribed in subsection (f)) received\nby such plan during the previous plan\nyear that were related to a prior\nauthorization requirement.\n``(XI) Such other information as\nthe Secretary determines appropriate.\n``(ii) The plan shall provide--\n``(I) to each provider or supplier\nwho seeks to enter into a contract with\nsuch plan to furnish applicable items\nand services under such plan, the list\ndescribed in clause (i)(I) and any\npolicies or procedures used by the plan\nfor making determinations with respect\nto prior authorization requests;\n``(II) to each such provider and\nsupplier that enters into such a\ncontract, access to the criteria used\nby the plan for making such\ndeterminations and an itemization of\nthe medical or other documentation\nrequired to be submitted by a provider\nor supplier with respect to such a\nrequest; and\n``(III) to an enrollee of the plan,\nupon request, access to the criteria\nused by the plan for making\ndeterminations with respect to prior\nauthorization requests for an item or\nservice.\n``(B) Option for plan to provide certain additional\ninformation.--As part of the information described in\nsubparagraph (A)(i) provided to the Secretary during a\nplan year, a Medicare Advantage plan may elect to\ninclude information regarding the percentage and number\nof specified requests made with respect to an\nindividual and an item or service that were denied by\nthe plan during the preceding plan year in an initial\ndetermination based on such requests failing to\ndemonstrate that such individuals met the clinical\ncriteria established by such plan to receive such items\nor services.\n``(C) Regulations.--The Secretary shall, through\nnotice and comment rulemaking, establish requirements\nfor Medicare Advantage plans regarding the provision\nof--\n``(i) access to criteria described in\nsubparagraph (A)(ii)(II) to providers of\nservices and suppliers in accordance with such\nsubparagraph; and\n``(ii) access to such criteria to enrollees\nin accordance with subparagraph (A)(ii)(III).\n``(D) Publication of information.--The Secretary\nshall publish information described in subparagraph\n(A)(i) and subparagraph (B) on a public website of the\nCenters for Medicare & Medicaid Services. Such\ninformation shall be so published on an individual plan\nlevel and may in addition be aggregated in such manner\nas determined appropriate by the Secretary.\n``(E) Medpac report.--Not later than 3 years after\nthe date information is first submitted under\nsubparagraph (A)(i), the Medicare Payment Advisory\nCommission shall submit to Congress a report on such\ninformation that includes a descriptive analysis of the\nuse of prior authorization. As appropriate, the\nCommission should report on statistics including the\nfrequency of appeals and overturned decisions. The\nCommission shall provide recommendations, as\nappropriate, on any improvement that should be made to\nthe electronic prior authorization programs of Medicare\nAdvantage plans.\n``(F) Specified request defined.--For purposes of\nthis paragraph, the term `specified request' means a\nprior authorization request made with respect to an\napplicable item or service.\n``(4) Enrollee protection standards.--For purposes of\nparagraph (1)(A)(ii), with respect to the use of prior\nauthorization by Medicare Advantage plans for applicable items\nand services, the enrollee protection standards specified in\nthis paragraph are--\n``(A) the adoption of transparent prior\nauthorization programs developed in consultation with\nenrollees and with providers and suppliers with\ncontracts in effect with such plans for furnishing such\nitems and services under such plans;\n``(B) allowing for the waiver or modification of\nprior authorization requirements based on the\nperformance of such providers and suppliers in\ndemonstrating compliance with such requirements, such\nas adherence to evidence-based medical guidelines and\nother quality criteria; and\n``(C) conducting annual reviews of such items and\nservices for which prior authorization requirements are\nimposed under such plans through a process that takes\ninto account input from enrollees and from providers\nand suppliers with such contracts in effect and is\nbased on consideration of prior authorization data from\nprevious plan years and analyses of current coverage\ncriteria.\n``(5) Applicable item or service defined.--For purposes of\nthis subsection, the term `applicable item or service' means,\nwith respect to a Medicare Advantage plan, any item or service\nfor which benefits are available under such plan, other than a\ncovered part D drug.\n``(6) Reports to congress.--\n``(A) GAO.--Not later than January 1, 2032, the\nComptroller General of the United States shall submit\nto Congress a report containing an evaluation of the\nimplementation of the requirements of this subsection\nand an analysis of issues in implementing such\nrequirements faced by Medicare Advantage plans.\n``(B) HHS.--\n``(i) The secretary.--Not later than the\nend of the fifth plan year beginning after the\ndate of the enactment of this subsection, and\nbiennially thereafter through the date that is\n10 years after such date of enactment, the\nSecretary shall submit to Congress a report\ncontaining a description of the information\nsubmitted under paragraph (3)(A)(i) during--\n``(I) in the case of the first such\nreport, the fourth plan year beginning\nafter the date of the enactment of this\nsubsection; and\n``(II) in the case of a subsequent\nreport, the 2 plan years preceding the\nyear of the submission of such report.\n``(ii) CMS.--Not later than January 1,\n2028, the Centers for Medicare & Medicaid\nServices and the Office of National Coordinator\nfor Health Information Technology shall submit\nto Congress and publish on the internet website\nof the Centers for Medicare & Medicaid Services\na report that--\n``(I) defines the term `real-time\ndecision' and details how the\ndefinition for such term may be updated\nbased on any technological advances;\n``(II) using the data submitted to\nthe Secretary under paragraph\n(3)(A)(i), details a process for real-\ntime decisions for routinely approved\nitems and services for purposes of the\nelectronic prior authorization program\ndescribed in paragraph (2); and\n``(III) includes an analysis of--\n``(aa) items and services\nthat are routinely approved;\n``(bb) items and services\nidentified in item (aa) that\ncould be eligible for real-time\ndecisions;\n``(cc) whether establishing\nreal-time decisions for such\nitems and services could--\n\n``(AA) improve\nenrollee access to\nbenefits under this\npart;\n\n``(BB) produce\noperational\nefficiencies for\nproviders and suppliers\nand Medicare Advantage\nplans; and\n\n``(CC) reduce\nhealth disparities for\nMedicare Advantage\nenrollees in rural and\nlow-income communities;\nand\n\n``(dd) how determinations\nof routinely approved items and\nservices made solely through\nautomation and artificial\nintelligence by Medicare\nAdvantage plans impact patient\naccess, including disparities\nin access for rural and low-\nincome beneficiaries.''.\n(b) Providing the Secretary Authority To Enforce Timely Responses\nfor All Prior Authorization Requests Submitted Under Part C.--Section\n1852(g) of the Social Security Act (42 U.S.C. 1395w-22(g)) is amended--\n(1) in paragraph (1)(A), by inserting ``and in accordance\nwith any timeframe established by the Secretary under paragraph\n(6)'' after ``paragraph (3)'';\n(2) in paragraph (3)(B)(iii), by inserting ``(with respect\nto prior authorization requests submitted on or after the first\nday of the third plan year beginning after the date of the\nenactment of the Improving Seniors' Timely Access to Care Act\nof 2025, any timeframe established by the Secretary under\nparagraph (6))'' after ``72 hours''; and\n(3) by adding at the end the following new paragraph:\n``(6) Timeframe for response to prior authorization\nrequests.--Subject to paragraph (3), the Secretary may\nestablish, for purposes of an organization determination made\nwith respect to a prior authorization request for an item or\nservice to be furnished to an individual, timeframes, such as\n24 hours, for the organization to notify the enrollee (and the\nphysician involved, as appropriate) of such determination for--\n``(A) a request for expedited determination\ndescribed in paragraph (3)(A);\n``(B) a real time decision for routinely approved\nitems and services; and\n``(C) any other prior authorization request.''.\n<all>","changes":[],"passport":{"data":{"act":{"jurisdiction":"США","title_official":"Improving Seniors' Timely Access to Care Act of 2025","title_short":"Закон о своевременном доступе пожилых людей к медицинской помощи 2025 г.","level":"закон","date_adopted":"2025-05-20","date_in_force":"","date_version":"","phased":"Электронный обмен данными начинается с плановых лет начиная с 1 января 2028 г.;\nРаскрытие информации начинается с плановых лет начиная с 1 января 2027 г.","status":"действует","sunset":"","regulator":"Центры медицинского обслуживания и медицинского страхования (CMS)","related":""},"goal":{"problem":"Недостаточная прозрачность и оперативность процедур предварительного согласования медицинских услуг в рамках программ Medicare Advantage","goal":"Повышение качества и доступности медицинской помощи пожилым людям за счет стандартизации и ускорения процессов предварительного согласования","targets":"Улучшение показателей удовлетворенности пациентов, сокращение времени ожидания решения по предварительным согласованиям","scope":"Программы Medicare Advantage, медицинские учреждения и страховые компании","exclusions":"Лекарства, покрываемые программой части D"},"subjects_note":{"protected":"Пенсионеры, участники программы Medicare Advantage"},"subjects":[{"role":"поставщик","who":"Медицинские учреждения и врачи, предоставляющие услуги участникам программы Medicare Advantage","criteria":"Наличие контракта с программой Medicare Advantage","count":"нет данных"},{"role":"оператор","who":"Страховые компании, управляющие планами Medicare Advantage","criteria":"Управление программой Medicare Advantage","count":"нет данных"}],"norms":[{"address":"Sec. 2(o)(1)(A)(i)","addressee":"оператор","essence":"С плановых годов начиная с 1 января 2028 г., планы Medicare Advantage должны внедрить электронную систему предварительного согласования","type":"обязанность","mechanism":"технологические требования, повышение эффективности работы","cost_channel":"капитальные, административные","cost_kind":"разовые, регулярные","trigger":"начало нового планового года","sanction":"","refs":"","form":"цифровая","in_force":"с плановых годов начиная с 1 января 2028 г.","ru_analog":"требует проверки"},{"address":"Sec. 2(o)(3)(A)(i)","addressee":"оператор","essence":"Начиная с плановых годов с 1 января 2027 г., операторы обязаны ежегодно предоставлять информацию о предварительном согласовании","type":"обязанность","mechanism":"информирование","cost_channel":"административный","cost_kind":"регулярные","trigger":"конец каждого планового года","sanction":"","refs":"","form":"цифровая","in_force":"с плановых годов начиная с 1 января 2027 г.","ru_analog":"требует проверки"},{"address":"Sec. 2(o)(3)(A)(i)(V)","addressee":"оператор","essence":"Операторам необходимо сообщать процент запросов, обработанных с использованием технологий искусственного интеллекта","type":"обязанность","mechanism":"информирование","cost_channel":"административный","cost_kind":"регулярные","trigger":"конец каждого планового года","sanction":"","refs":"","form":"цифровая","in_force":"с плановых годов начиная с 1 января 2027 г.","ru_analog":"требует проверки"},{"address":"Sec. 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интеллекта и их влияние на принятие решений","type":"обязанность","mechanism":"информирование","cost_channel":"административный","cost_kind":"регулярные","trigger":"конец каждого планового года","sanction":"","refs":"","form":"цифровая","in_force":"с плановых годов начиная с 1 января 2027 г.","ru_analog":"требует проверки"},{"address":"Sec. 2(o)(3)(A)(i)(X)","addressee":"оператор","essence":"Сообщать количество жалоб, связанных с процедурами предварительного согласования","type":"обязанность","mechanism":"информирование","cost_channel":"административный","cost_kind":"регулярные","trigger":"конец каждого планового года","sanction":"","refs":"","form":"цифровая","in_force":"с плановых годов начиная с 1 января 2027 г.","ru_analog":"требует проверки"},{"address":"Sec. 2(o)(3)(A)(ii)","addressee":"поставщик","essence":"Поставщики должны получать доступ к критериям принятия решений по предварительным согласованиям","type":"право","mechanism":"обеспечение доступа к 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