RNS Advocacy: Capitol Update – May 2024

This month, there were a few developments on an area of key importance to RNS: utilization management reform. The Improving Seniors Timely to Care Act will be reintroduced on June 5th and RNS was given the opportunity to endorse the legislation prior to its reintroduction. This bill would reform prior authorization processes for the use of prior authorization by Medicare Advantage (MA) plans. Interestingly, it passed the House in the last Congress but did not advance in the Senate due to a large score by the Congressional Budget Office (CBO). The bill’s champions worked with the CBO to minimize the score as much as possible – and received an assist from the Centers for Medicare and Medicaid Services (CMS) when the agency proposed and finalized via regulation some of the changes the legislation had proposed making.

The Improving Seniors Timely Access to Care Act would still allow for the use of prior authorization by MA plans but would require insurers to establish electronic processes that meet standards established by the Department of Health and Human Services. RNS endorsed the legislation and will work to get it enacted before the end of this Congress. Another kind of utilization management that creates significant access challenges for patients is step therapy. The Safe Step Act would reform step therapy protocols in employer-sponsored plans and RNS has previously advocated for this legislation during its D.C. Advocacy Day. On May 17th, RNS joined over 100 other organization on a letter to the House Education and Workforce Committee, urging the Committee to advance the Safe Step Act. This Committee is one of the congressional committees with jurisdiction over the legislation, so it must advance the legislation before it can advance to the Floor.

Finally, the Senate passed a resolution (S.Res.676) in support of National Nurses Week, which was the week of May 6th. Congress occasionally passes resolutions such as this one in support of notable people and professions or to draw attention to certain disease states. In this case, the resolution highlighted many positive aspects of the nursing profession, including the fact that nurses are “the cornerstone” of our healthcare infrastructure and positively impact people at every stage of life. As a reminder, if you’d like to become more involved in our advocacy work, please drop us a line: advocacy@rnsnurse.org