More than 370 patient and provider organizations endorsed legislation this week that would reform prior authorization requirements in Medicare Advantage, a bill that Powers Principals Peggy Tighe and Diane Millman helped draft and advance through their work with the Regulatory Relief Coalition (RRC).

Introduced by Reps. Suzan DelBene (D-WA), Mike Kelly (R-PA), Roger Marshall, MD (R-KS), and Ami Bera, MD (D-CA), the bipartisan Improving Seniors’ Timely Access to Care Act (H.R. 3107) would help protect patients from unnecessary delays in care by streamlining and standardizing prior authorization under the Medicare Advantage program, providing oversight and transparency of health insurance for America’s seniors.

This week, the RRC announced that more than 370 national and state patient, physician, health care professional, and other health care stakeholder organizations sent a letter to Congress urging lawmakers to pass the bill. Peggy serves as the lead legislative counsel for the RRC and Diane serves as regulatory counsel.  RRC is a group of ten national physician specialty organizations that was instrumental in developing and advancing the legislation, as well as leading efforts to secure support from the health organizations named in the letter.

Peggy’s work was recently noted in a Modern Healthcare article on the push for prior authorization reform. In reference to pushback against the bill’s transparency measures, Peggy is quoted as saying, “The opposition as I understand it to the transparency element of this is based on patients being able to know how the MA insurers use prior (authorization) to deny care. And to us that’s indefensible.”

Peggy works closely with both the Healthcare and Government Relations & Public Policy teams at Powers. She teams with health systems, patient groups, and provider organizations to develop persuasive policy arguments and strategies to influence Congress and relevant agencies, creating change to protect and support providers and the patients they serve.

She focuses her practice on lobbying, coalition building, crafting and implementing grassroots campaigns, and coordinating media relations. She has experience strategizing and implementing federal grassroots activities, including grasstops (high-level grassroots), coalition building, letter writing, and database building.

Diane is a principal in the firm’s Healthcare practice. She represents physicians, ambulatory care providers, and professional and trade associations before the Centers for Medicare and Medicaid Services and other federal agencies, as well as before Congress on various Medicare and Medicaid payment, fraud and abuse, physician self-referral, and other issues arising under federal law.

To learn more about the RRC or efforts to reform prior authorization, Peggy Tighe can be reached at Peggy.Tighe@PowersLaw.com or 202-875-6752. Diane Millman can be reached at Diane.Millman@PowersLaw.com or 202-872-6725.

Leave a Reply