Regulatory Burden
Priority Issues
Physicians, including neurologists, face growing administrative requirements from the federal government, insurers, and their institutions. Despite the medical community constantly working towards providing more efficient high-quality patient care, they are forced to adhere to many redundant and ineffective processes. Neurologists need relief from overwhelming regulatory requirements, so they may prioritize caring for patients with complex diseases of the brain and nervous system.
The AAN supports reducing physician regulatory and administrative burdens such as prior authorization, step therapy requirements, quality reporting, and other administrative tasks so that neurology providers can spend less time on administrative tasks and more time on patient care.
AAN Supports
Additional Resources
Act Now on Regulatory Burden
Contact your legislators and urge their support on the Improving Seniors’ Timely Access to Care Act (S. 4532/H.R. 8702), which would streamline the prior authorization process in Medicare Advantage and increase transparency.
Regulatory burden in Neurology Progress
The AAN has been hard at work to advocate for federal reforms to prior authorization with both Congress and the administration:
- CMS finalized two crucial rules in April 2023 and January 2024 that fundamentally reform how Medicare Advantage (MA) plans may implement utilization management policies including prior authorization.
- The AAN has since responded to a Request for Information regarding further reforms to prior authorization. It is committed to working with CMS to strengthen the MA program by ensuring that care is not inappropriately denied or delayed and that MA beneficiaries maintain robust access to neurological care.
- On June 12, 2024, the Improving Seniors’ Timely Access to Care Act was introduced in both chambers of Congress.
- This bill, which will help reduce the administrative burden faced by physicians due to prior authorization requirements in MA plans, has been a top priority of the AAN since its first introduction in 2019.
- The AAN worked closely with bill sponsors and the Regulatory Relief Coalition to ensure the bill’s reintroduction and will continue to work to urge Congress to pass the legislation before the end of the year.
At the state level, the AAN has been actively advocating for prior authorization reform legislation.
- In 2024, the AAN celebrated wins in Colorado, New Jersey, Oklahoma and Vermont, streamlining the prior authorization process and reducing barriers faced by patients and their physicians that delay access to treatment.
- In Colorado, the legislation included provisions requiring the establishment of an exemptions program to remove the administrative burdens associated with prior authorization for qualified providers.
- Further, the Vermont legislation mandated that health insurance plans using step therapy protocols must not require patients to fail the same medication more than once and must grant exceptions under specific conditions, such as adverse reactions or lack of efficacy.
Comment Letters
- AAN Joins Comments on Electronic Prior Authorization Proposed Rule | Posted March 13, 2023
- AAN Commends CMS on Implementation of Requirements to Reduce Prior Authorization Burden | Posted February 24, 2023
- AAN Reiterates Request for Step Therapy Prohibition for Medicare Advantage Part B Drugs | Posted February 13, 2023
- AAN Joins Recommendations to Improve Prior Authorization in Medicare Advantage Following 2024 Proposed Rule | Posted February 13, 2023
- AAN Joins Comments on Prior Authorization Reform in Medicare Advantage | Posted February 13, 2023
- AAN Joins Response to Request for Information on Step Therapy in Essential Health Benefits (EHB) | Posted January 31, 2023
- AAN Urges CMS to Improve Oversight of Prior Authorization in Medicare Advantage Plans | Posted January 30, 2023