WASHINGTON – Today, U.S. Sens. Mark R. Warner and Tim Kaine announced their support for legislation crafted by Senate Appropriations Committee Vice Chair Patty Murray (D-WA) and House Appropriations Committee Ranking Member Rosa DeLauro (D-CT-03) to fund the federal government through October 31; protect Americans’ health care by reversing Republicans’ Medicaid cuts and preventing Affordable Care Act premiums from skyrocketing; and prohibit the Trump Administration from illegally withholding funding appropriated by Congress:

“President Trump’s disastrous policies mean we’re on the brink of skyrocketing health care premiums and clinics closing their doors—consequences that will impact Americans regardless of their politics. But what is Trump doing? He’s telling congressional Republicans not to work with Democrats to fund the government. If only he cared half as much about working together in good-faith as he cares about giving tax breaks to billionaires. Meanwhile, Democrats have been talking with their constituents across the country from both sides of the aisle and came up with a much better idea. Our legislation would avert a shutdown, protect Americans’ health care and keep premium costs down, and prevent the Trump Administration from illegally withholding funding approved by bipartisan majorities in Congress, and it should be put to a vote.”

Trump must sign legislation to fund the government on or before September 30 to avert a government shutdown.

FRANKLIN, Va. – In case you missed it, U.S. Sen. Mark R. Warner (D-VA) and Virginia House of Delegates Speaker Don Scott on Tuesday traveled to Franklin’s Hayden Village Center to sit down with Franklin community members and leaders who rely on Southampton Medical Center – one of the six rural hospitals in Virginia and more than 300 rural hospitals across the nation that are now at disproportionate risk of closure, conversion, or dramatic service reductions following passage of the “Big Beautiful” Republican budget law.

Key Quotes from Sen. Warner: View Clip HERE

• “I’ve been governor and senator for a long time. I think this may be the worst piece of legislation I’ve ever seen in my life, and that’s saying something.”

• “At the end of the day, this bill was about providing a giant tax cut disproportionately for the most successful Americans. And I’m all for success. I’m a businessman. I’m a capitalist. But the cost of paying for that extraordinary tax cut, we are taking in many ways the heart out of health care for Americans who are the most vulnerable.”

• “This was not a bipartisan bill. This was one team driving through a piece of legislation that will have huge, huge ramifications. The Big Ugly Bill will cut a trillion dollars out of Medicaid.” 

• “300,000 Virginians will lose their health insurance. Those people are not going to disappear. They’re going to simply show up at the emergency room. And if the hospital closes here, they’re going to have to spend a lot of time checking the traffic to see how to get to Portsmouth or Petersburg to get basic access to health care.” 

• “The mayor was talking a little bit about some of the challenges Franklin’s got now. If we’re going to recruit additional businesses here, keep our businesses that we’ve got, we’ve got to have local health care. That is the starting point.”

Key Quotes from Speaker Don Scott: View Clip HERE

• “Take the politics out of it and just deal with the math. You can’t deliver the same amount of services for substantially less resources. It’s impossible. This is math. You can’t argue with math. You can argue with a whole lot of stuff, but math is math. You can’t do the same thing that you used to do for one more dollar when you only have a dime.” 

• “What the Senator was talking about when he talked about the [enhanced Premium Tax Credit] subsidy, these are people who are working every day. These are people who are working hard, playing by the rules, families with children and they need the subsidy to be able to make up for the difference, that delta that happens between what they can afford and what they need. And that subsidy is paid for by people who have benefited from America in a real way, very wealthy people who have been able to benefit from our system. Why shouldn’t they give a little bit more back? As the Senator said, I’m a capitalist, too. I’m a trial lawyer. I love to get paid, love to make money, don’t get it twisted. But I’m also very grateful to be in a country where we have a system where somebody like me who should never be where I’m supposed to be … Only in America am I even possible. So I’m grateful to pay my fair share back. We have people who are billionaires who don’t want to pay their fair share back.”

Key Quotes from Mona Murphy, lifelong resident of Franklin, Va.: View Clip HERE

• “The potential closure of Franklin’s hospital … would have devastating consequences for our community. The closure of our hospital would leave [families] without accessible health care, forcing them to travel 20 miles to Suffolk, Virginia for medical services. For many, this distance is overwhelming due to financial constraints or lack of transportation options.”

• “Franklin is striving to rebuild itself through educational advancements, attempts at attracting new businesses and encouraging young families to settle here. However, the loss of the hospital would severely hinder these efforts … As someone who works closely with families and children in our schools, I see the dire need for accessible health care in our city every day. Emergencies are unpredictable and the absence of a nearby hospital could have life-threatening consequences for our students and residents. I can’t even imagine a scenario where a child’s life hangs in the balance because we lack immediate access to medical care.”

Event Coverage

• 13NewsNow: Southampton Medical Center at risk of closure after Medicaid cuts hit rural hospitals

• Cville Right Now: Sen. Warner meets with people who receive care at a rural hospital that could face closure

• Virginia Mercury: Federal, state lawmakers call on Va. hospitals to ‘be transparent’ about federal funding changes

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WASHINGTON – Today, U.S. Sens. Mark R. Warner and Tim Kaine (both D-VA) issued the following statement after the Virginia State Corporation Commission (SCC) reported that premiums for Affordable Care Act Marketplace coverage are projected to rise by an average of 20.5% next year – a spike driven largely by the expiration of enhanced premium tax credits that have helped make health care more affordable for hundreds of thousands of Virginians:

“The news that Virginians who rely on health care coverage from the marketplace could see their premiums jump by more than 20% next year is deeply troubling. This entirely-avoidable increase is being driven by the expiration of enhanced premium tax credits that have helped hundreds of thousands of Virginians afford quality health care. While President Trump and congressional Republicans bent over backward to extend tax cuts for the uber-wealthy as part of their tax and budget bill, they chose not to renew these critical health care credits that have saved the average Virginian nearly $90 a month. Alongside our Democratic colleagues, we even forced a vote on an amendment to the bill to extend the credits, and Republicans voted it down.

“We know what’s at stake when health care becomes unaffordable: families go without coverage, people skip doctor visits and prescriptions, and small health problems turn into costly emergencies. That’s not only bad for public health, it drives up costs for everyone. We remain committed to restoring these critical tax credits and bringing down health care costs, and we call on our colleagues in Congress to put politics aside and act now to prevent this needless premium spike from hurting Virginia families.”

The enhanced premium tax credits were first enacted during the COVID-19 pandemic to lower monthly Affordable Care Act marketplace premiums for American families. President Trump’s tax and budget bill, passed by the Republican majority in Congress over Warner and Kaine’s strong opposition, did not extend these credits. As a result, Virginians who purchase coverage on the Virginia marketplace will see the largest share of next year’s premium hikes directly tied to the loss of these credits. Without action, more than a third of the nearly 415,000 Virginians who currently rely on this coverage could be priced out of their health insurance, according to the SCC Bureau of Insurance.

Last month, Warner and Kaine introduced legislation to repeal the health care provisions in President Trump and Republicans’ ‘Big, Ugly Bill’ and permanently extend the Affordable Care Act’s enhanced tax credits.

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WASHINGTON — U.S. Sens. Mark R. Warner (D-VA) and John Thune (R-SD) today reintroduced the Equitable Community Access to Pharmacist Services (ECAPS) Act, bipartisan legislation that would ensure seniors can continue to access important clinical services from their pharmacist. The bill would allow Medicare to reimburse for certain pharmacist-administered tests, treatments, and vaccinations for illnesses like influenza, respiratory syncytial virus (RSV), and strep throat, in accordance with state scope-of-practice laws. 

“Seniors across South Dakota rely on the care and support they receive from their community pharmacists,” said Thune. “I am proud to lead this commonsense legislation that would allow these services and other important treatments to remain a reliable option for seniors, particularly in our rural communities.” 

“During the pandemic, we saw firsthand how pharmacists stepped up to meet urgent health care needs, especially in underserved and rural communities,” said Warner. “This bill builds on that progress by making sure seniors can continue to count on their local pharmacists for routine tests, vaccines, and treatments for common illnesses like flu and COVID. This is a practical step to improve access to care, reduce the burden on hospitals and clinics, and make our health system work better for seniors.”

“In rural states like South Dakota, pharmacists are often the most accessible – and sometimes the only – health care provider available to patients,” said Amanda Bacon, executive director of the South Dakota Pharmacists Association. “The ECAPS Act recognizes the vital role pharmacists play on the front lines of care, especially in areas where access is limited by geography, provider shortages, or both. The South Dakota Pharmacists Association strongly supports this legislation and the critical role it plays in strengthening our rural health care system. The ECAPS Act helps keep care close to home – and in South Dakota, that makes all the difference.” 

“We applaud Senator Warner and Senator Thune for championing the reintroduction of the ECAPS Act,” said Jamie Fisher, executive director of the Virginia Pharmacy Association. “This bipartisan legislation recognizes what patients across Virginia already know – pharmacists are vital, trusted, and accessible members of the health care team. By ensuring Medicare beneficiaries can receive essential services like flu, COVID-19, RSV, and strep testing and treatment from their local pharmacist, the ECAPS Act will improve health outcomes, particularly in rural and underserved communities where access to care is often limited. We strongly support this effort to expand access and equity in health care.” 

“The Future of Pharmacy Care Coalition commends Senate Majority Leader John Thune and Senator Mark Warner for championing the ECAPS Act to ensure seniors, including those living in rural areas and vulnerable communities, can turn to their local pharmacists for testing and treatment services that can protect them from certain common respiratory conditions,” said the Future of Pharmacy Care Coalition. “Congress must move with urgency to provide seniors with Medicare coverage in states where pharmacists can offer testing and treatment services for conditions that, although common, can quickly become life-threatening if not properly managed.”

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WASHINGTON – U.S. Sen. Mark R. Warner D-Va. and Senate Finance Committee Ranking Member Ron Wyden, D-Ore. called for the Trump administration to share its plan to prevent cyberattacks on rural hospitals following the largest health care cuts in American history in the Republican budget bill. 

“Trumpcare will harm the cybersecurity resiliency of rural and small hospitals just as this Administration has chosen to gut cybersecurity operations at HHS,” Wyden and Warner wrote. “As rural and small hospitals confront even lower operating margins due to Republican health care cuts, they will be less likely to prioritize spending on cybersecurity infrastructure. The lack of federal oversight and resources, coupled with historic cuts to Medicaid and the ACA, only serve to increase rural and small hospitals’ cybersecurity vulnerabilities.” 

The letter, sent to Department of Health and Human Services (HHS) Secretary Robert F. Kennedy, Jr. and Centers for Medicare & Medicaid Services (CMS) Administrator Mehmet Oz, calls on the Administration to share its plans to help small and rural hospitals meet federal cybersecurity standards, as well as its plan to use the so-called “rural health transformation program” to fund cybersecurity improvements - a fund that is dwarfed by more than $1 trillion in cuts to Medicaid and the Affordable Care Act (ACA)  under Trumpcare. 

Hospitals, particularly smaller facilities and those in rural areas, are a prime target for cyber criminals. Hospitals are also very likely to pay a ransom in order to maintain the continuity of health care given the lack of nearby providers, especially emergency services and procedures, and their top priority is protecting the health and well-being of patients they serve.

Last year, Wyden and Warner introduced legislation to strengthen federal cybersecurity standards across the health care system. Independent analysis has confirmed that over 330 rural hospitals are at risk of deep financial hardship or even closure due to Trumpcare’s cuts to Medicaid, forcing facilities into impossible choices to stay open and continue serving their community.

The full letter is here.

A web version of this release is here.

WASHINGTON - Today, U.S. Sens. Mark R. Warner (D-VA) and Roger Marshall (R-KS) and U.S. Reps. Mike Kelly (PA-16), Suzan DelBene (WA-01), John Joyce, M.D. (PA-13), and Ami Bera, M.D. (CA-06), co-leads of the bipartisan Improving Seniors’ Timely Access to Care Act, released the following joint statement after an announcement Monday from U.S. Health & Human Services (HHS) Secretary Robert F. Kennedy, Jr. and Centers for Medicare and Medicaid (CMS) Administrator Dr. Mehmet Oz that pledges to ease the Medicare Advantage prior authorization process.

The pledge, which includes several provisions contained in their legislation, follows years of legislative progress led by Kelly and Congressional colleagues.

"We applaud these commitments, which aims to improve health care access for millions of Americans by easing the Medicare Advantage prior authorization process," the Members said. "We encourage our House and Senate colleagues to carry this momentum forward and to pass our life-changing legislation, the Improving Seniors’ Timely Access to Care Act, to ensure this progress becomes law."

Under the commitment, participating health plans would:

• Standardize electronic prior authorization submissions using Fast Healthcare Interoperability Resources (FHIR®)-based application programming interfaces.
• Reduce the volume of medical services subject to prior authorization by January 1, 2026.
• Honor existing authorizations during insurance transitions to ensure continuity of care.
• Enhance transparency and communication around authorization decisions and appeals.
• Expand real-time responses to minimize delays in care with real-time approvals for most requests by 2027.
• Ensure medical professionals review all clinical denials.
   

In May 2025, Sen. Warner reintroduced the Improving Seniors’ Timely Access to Care Act. Prior authorization is a tool used by health plans to reduce unnecessary care by requiring health care providers to get pre-approval for medical services. But it’s not without fault. The current system often results in unconfirmed faxes of a patient’s medical information or phone calls by clinicians which takes precious time away from delivering quality and timely care. Prior authorization continues to be the #1 administrative burden identified by health care providers, and three out of four Medicare Advantage enrollees are subject to unnecessary delays due to prior authorization. In recent years, the Office of the Inspector General at the U.S. Department of Health and Human Services (HHS) raised concerns after an audit revealed that Medicare Advantage plans ultimately approved 75% of requests that were originally denied. More recently, HHS OIG released a report finding that MA plans incorrectly denied beneficiaries’ access to services even though they met Medicare coverage rules.

Health plans, health care providers, and patients agree that the prior authorization process must be improved to better serve patients and reduce unnecessary administrative burdens for clinicians. In fact, leading health care organizations released a consensus statement to address some of the most pressing concerns associated with prior authorization.

Specifically, the legislation would:

• Establish an electronic prior authorization process for MA plans including a standardization for transactions and clinical attachments.
• Increase transparency around MA prior authorization requirements and its use.
• Clarify HHS’ authority to establish timeframes for e-prior authorization requests including   expedited determinations, real-time decisions for routinely approved items and services, and other prior authorization requests.
• Expand beneficiary protections to improve enrollee experiences and outcomes.
• Require HHS and other agencies to report to Congress on program integrity efforts and other ways to further improve the e-PA process.
• Previously, Rep. Kelly led similar legislation in the 118th Congress. The Improving Seniors’ Timely Access to Care Act unanimously passed the House in the 117th Congress and was cosponsored by a majority of members in the Senate and House of Representatives. 

Text of the bill can be found here and a section-by-section can be found here.

WASHINGTON – U.S. Sens. Mark R. Warner and Tim Kaine (both D-VA) today issued the following statement slamming congressional Republicans’ bill that would devastate rural communities across Virginia by gutting Medicaid and accelerating hospital closures:

“The big GOP plan is a direct threat to families in rural Virginia who rely on Medicaid to access care and keep their community hospitals open. This bill would strip health care from thousands of Virginians, gut funding for struggling rural hospitals, and undo decades of progress. Almost forty percent of kids in rural Virginia are covered by Medicaid. Without that lifeline, families would face impossible choices, and many local hospitals wouldn’t survive. For rural Virginia, this bill might mean the difference between a hospital that’s five minutes away and one that’s 50. It is a slap in the face to the health care workers, parents, and local leaders doing everything they can to keep their communities afloat. We refuse to stand by while Republicans gamble with Virginians’ lives.”

Small towns and rural areas in Virginia have the highest rates of Medicaid coverage. According to research by the Georgetown Center for Children and Families:

• 37.9 percent of children in Virginia’s small towns and rural areas rely on Medicaid/CHIP for their coverage, compared to 30 percent in metro/urban areas;
• Among Virginia adults younger than 65, 18.9 percent of those in small towns and rural areas get their coverage through Medicaid/CHIP, compared to 13.7 percent in metro areas; and
• Among seniors, 11.7 percent of those living in Virginia’s small towns and rural areas were covered by Medicaid, compared to 10.7 percent in metro/urban areas.

Nearly half – 47 percent – of rural births in the U.S. are covered by Medicaid, as are 65 percent of nursing home residents in rural counties.

Almost half of rural hospitals nationwide are already operating at a financial loss, according to the American Hospital Association. The GOP’s proposed Medicaid cuts would push already-struggling rural hospitals further toward financial collapse, particularly in areas like Southwest and Southside Virginia. Detailed data from the Cecil G. Sheps Center for Health Services Research at the University of North Carolina at Chapel Hill concluded that Republican health care cuts could place more than 300 rural hospitals across the U.S. – including six hospitals in Southwest and Southside Virginia – at disproportionate risk of closure, conversion, or service reductions.

Since the Affordable Care Act expanded Medicaid in Virginia, the uninsured rate has fallen dramatically, and rural hospitals have seen a critical infusion of funds to help keep their doors open. The GOP’s plan to give giant tax cuts to the ultra wealthy while slashing Medicaid and other investments threatens to reverse that trend.

Warner and Kaine have long championed Medicaid expansion and rural health infrastructure, including broadband-enabled telehealth services and rural hospital stabilization programs. They have pledged to fight the GOP plan as long as Republicans in Congress continue to insist on gutting vital programs in order to pay for tax breaks for the richest Americans, noting that the GOP bill would strip health insurance from more than 302,000 Virginians, cut SNAP benefits, raise energy costs for Virginia households, jeopardize more than 20,000 Virginia jobs, raise taxes on minimum wage workers while giving the richest 0.1% a $188,000 tax cut, make tax filing more expensive, and explode the deficit, among other devastating impacts to Virginia families.

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WASHINGTON – Today, U.S. Sens. Mark R. Warner and Tim Kaine (D-VA) issued the following statement after Republicans in the House of Representatives voted in the dead of night to approve legislation to cut taxes for the ultra-wealthy while slashing Medicaid and nutrition assistance, raising taxes on working families, and exploding the national debt:  

“This bill would do real harm to Virginia families, workers, and communities. It would raise taxes on working families and rip health care away from more than 262,000 people in Virginia in order to give tax breaks to Donald Trump and his billionaire friends. Virginians deserve better, and we will oppose this bill with everything we’ve got as it comes to the Senate. “

Warner and Kaine have been sounding the alarm about the effects of the GOP plan on Virginia if Republicans in Congress continue to insist on gutting vital programs in order to pay for tax breaks for the richest Americans, noting that the GOP bill would strip health insurance from more than 262,000 Virginians; rip nutrition assistance away from at least 204,000 Virginians, including children; raise energy costs for Virginia households; jeopardize more than 20,000 Virginia jobs; and raise taxes on minimum wage workers while giving the richest 0.1% a $188,000 tax cut.

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WASHINGTON –U.S. Sens. Mark Warner (D-VA) and Roger Marshall, M.D. (R-Kansas) today reintroduced the Improving Seniors’ Timely Access to Care Act – bipartisan, zero-cost legislation to improve access to care for seniors enrolled in Medicare Advantage (MA) plans. The bill focuses on streamlining the often cumbersome and time-consuming prior authorization process, ultimately allowing healthcare providers to spend more time on patient care rather than administrative burdens.

This legislation would help physicians better serve and improve care for the 32.8 million Americans.

“Our seniors deserve high-quality care delivered in a timely fashion. I am proud to introduce this legislation that takes commonsense steps to modernize the prior authorization process, cutting through red tape, streamlining approvals, and making sure our health care providers are focused on what really matters — supporting their patients,” Sen. Warner said.

“Prior authorization is the number one administrative burden facing physicians today across all specialties,” Sen. Marshall said. “As a physician, I understand the frustration this arbitrary process is causing health care practices across the country and the headaches it creates for our nurses. With the bipartisan, bicameral Improving Seniors’ Timely Access to Care Act, we will streamline prior authorization and help improve patient outcomes and access to quality care.”

Joining Sens. Warner and Marshall are U.S. Sens. Maggie Hassan (D-NH), John Fetterman (D-PA), Amy Klobuchar (D-MN), Bill Cassidy (R-LA), Shelley Moore Capito (R-WV), John Hickenlooper (D-CO), James Lankford (R-OK), Jeff Merkley (D-OR), Marsha Blackburn (R-TN), Cynthia Lummis (R-WY), Cindy Hyde-Smith (R-MS), Tim Kaine (D-VA), Jeanne Shaheen (D-NH), Mike Rounds (R-SD), Alex Padilla (D-CA), Bill Hagerty (R-TN), Andy Kim (D-NJ), John Boozman (R-AK), Dick Durbin (D-IL), John Cornyn (R-TX), Patty Murray (D-WA), Jerry Moran (R-KS), Kirsten Gillibrand (D-NY), Maria Cantwell (D-WA), Mazie Hirono (D-HI), Thom Tillis (R-NC), Cory Booker (D-NJ), Tina Smith (D-MN), Peter Welch (D-VT), Sheldon Whitehouse (D-RI), Ted Budd (R-NC), Catherine Cortez Masto (D-NV), Tim Sheehy (R-MT), Tammy Baldwin (D-WI), Pete Ricketts (R-NE), Richard Blumenthal (D-CT), Elizabeth Warren (D-MA), Tammy Duckworth (D-IL), John Hoeven (R-ND), Rick Scott (R-FL), Mark Kelly (D-AZ), Jacky Rosen (D-NV), Martin Heinrich (D-NM), Deb Fischer (R-NE) and Chris Coons (D-DE).

“Too often, seniors face unnecessarily complicated and burdensome prior authorization processes that can become a barrier to receiving care,” Sen. Hassan said. “This bipartisan legislation is a commonsense way to support seniors on Medicare Advantage in accessing care, and to help health care providers focus on their patients instead of paperwork.”

“Prior authorization places more importance on process than patients. As a doctor, I want that to change. Let’s make sure seniors are receiving timely care,” Sen. Cassidy said. 

“Too often, seniors have to wait to receive vital care because of administrative burdens like prior authorization. I’m proud to join my colleagues in introducing the Improving Seniors’ Timely Access to Care Act, which will streamline prior authorization and reduce unnecessary health care delays,” Sen. Capito said.

“Seniors across the Cowboy State rely on Medicare, but too often, bureaucratic red tape gets in the way of timely care,” Sen. Lummis said. “I am proud to join my colleagues across the aisle to streamline the prior authorization process and put patients over paperwork.”

“Excessive administrative burdens within the Medicare Advantage program means too many seniors receive delayed benefits, while our health care providers are overwhelmed by paperwork. The current system isn’t working well for anyone, and it’s time we take meaningful action to fix it. This commonsense legislation is a necessary step in the right direction,” Sen. Hyde-Smith said.

“Health care providers handling mountains of paperwork takes up valuable time and can unnecessarily delay older folks’ access to the crucial care they need,” Sen. Kaine said. “I’m proud to champion this bipartisan legislation to modernize and streamline health care processes to ensure that Americans covered by Medicare Advantage can more swiftly access care and empower health care providers to direct more of their time to their patients.”

“Quality, expedited medical care should always be within reach for seniors, and our providers deserve a system that helps them focus on delivering it,” Sen. Boozman said. “I’m pleased to join this bipartisan effort to end the inefficient process that delays Medicare Advantage beneficiaries’ evaluations and treatments while removing an unnecessary, bureaucratic burden on clinicians.”

“Doctors and health care providers are too often bogged down by unnecessary burdens, which can lead to delayed care and negative outcomes for patients,” Sen. Cornyn said. “By streamlining the prior authorization process under Medicare Advantage, this legislation would cut red tape, improve enrollee experiences, and ensure seniors receive the timely care they deserve.

“Improving the prior authorization process will help seniors have quicker access to the health care they need and remove administrative hurdles for physicians,” Sen. Moran said. “This legislation would make commonsense changes to better support thousands of seniors in Kansas and remove the red tape that is costing doctors and patients valuable time.”

“Senior citizens have spent their entire lives contributing to our communities, and they deserve every resource to support their health and well-being,” Sen. Gillibrand said. “The Improving Seniors’ Timely Access to Care Act will help cut through unnecessary red tape and ensure timely medical care is accessible to older Americans. Seniors should have reliable access to specialist care, mental health support, preventative services, and the treatments they need to live with dignity. I am proud to support this important legislation, and I pledge to continue fighting to expand access to quality, affordable, and timely health care for our seniors.” 

“Seniors with Medicare Advantage plans should not have to endure unnecessary delays when seeking medical treatment, and sometimes even life-saving care,” Sen. Hirono said. “This legislation will help to reduce these arbitrary waiting periods, streamlining prior authorization processes to ensure that health care providers can treat and care for their patients in an efficient manner.”

“North Carolina seniors shouldn’t face unnecessary delays when trying to access the care they need through Medicare Advantage,” Sen. Tillis said. “I’m proud to support this bipartisan, commonsense legislation that streamlines the prior authorization process, cuts red tape for providers, and ensures patients get timely access to treatment.”

U.S. Reps John Joyce, M.D. (R-PA-13), Mike Kelly (R-PA-16), Suzan DelBene (D-WA-01), and Ami Bera, M.D. (D-CA-06) introduced companion legislation in the House of Representatives.

This legislation is supported by the Better Medicare Alliance, Humana, and 138 other health care organizations.

“Prior authorization helps keep health care costs low and ensures seniors are getting the most appropriate care. But the process should be easier. The changes put forth in this legislation are long overdue and will help ensure seniors can get the care they need without delay,” Mary Beth Donahue, President and CEO of Better Medicare Alliance, said. “We are proud to support this bill and thank Senators Marshall and Warner, and Representatives Kelly, DelBene, Bera, and Joyce for their leadership. We look forward to continued work on this issue with Congress and the Administration.”

“Humana’s job is to ensure our members have access to high quality, affordable healthcare.  We support efforts in the House and Senate to move the Seniors’ Timely Access to Care Act forward quickly,” Jim Rechtin, Humana CEO, said. “It is a common-sense approach to making healthcare easier by modernizing the prior authorization process.”

Background:

• Prior authorization is a tool used by health plans to reduce unnecessary care by requiring health care providers to get pre-approval for medical services. However, the current system often results in multiple faxes or phone calls by clinicians, which takes precious time away from delivering care.
• Prior authorization continues to be the number-one administrative burden identified by health care providers, and nearly three out of four Medicare Advantage enrollees are subject to unnecessary delays due to the practice.
• The bill would codify and enhance elements of the Advancing Interoperability and Improving Prior Authorization Processes (e-PA) rule that was finalized by the Centers for Medicare & Medicaid Services (CMS) on January 17, 2024.
• Last Congress, the bill was supported by a super majority of members in the Senate (60) and a majority in the House (232), and was unanimously passed by the House in 2022.
• In 2018, the Office of the Inspector General at the U.S. Department of Health and Human Services (HHS) raised concerns after an audit revealed that Medicare Advantage plans ultimately approved 75% of requests that were originally denied.
• In 2022, the HHS Office of Inspector General released a report finding that MA plans incorrectly denied beneficiaries’ access to services even though they met Medicare coverage rules.

The Improving Seniors’ Timely Access to Care Act would:

• Establish an electronic prior authorization process for Medicare Advantage plans, including a standardization for transactions and clinical attachments.
• Increase transparency around Medicare Advantage prior authorization requirements and their use.
• Clarify HHS’ authority to establish timeframes for e-prior authorization requests, including expedited determinations, real-time decisions for routinely approved items and services, and other prior authorization requests.
• Expand beneficiary protections to improve enrollee experiences and outcomes.
• Require HHS and other agencies to report to Congress on program integrity efforts and other ways to further improve the e-prior authorization process.
• Result in a zero cost to American taxpayers.

The full text of the legislation can be found here.

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WASHINGTON – Today, U.S. Sens. Mark R. Warner (D-VA) and Marsha Blackburn (R-TN) introduced the Rural Patient Monitoring (RPM) Access Act to ensure Medicare patients in rural and underserved communities have access to remote physiologic monitoring services, which lower costs and improve access to care by using technology to collect and transmit patient health data to healthcare providers.

“Too often, patients are struggling to receive the medical care they need because of how difficult it is to see a doctor in person,” said Sen. Warner. “Remote monitoring services offer a life-saving solution, expanding care options and allowing individuals to regularly receive the medical consultations they need, all while lowering costs and hospital admissions. I’m proud to introduce the Rural Patient Monitoring Access Act to improve health care services for our seniors.”

“Medicare beneficiaries in rural and underserved areas often face serious barriers to health care, and they deserve better,” said Sen. Blackburn. “The Rural Patient Monitoring Access Act would ensure Tennessee Medicare patients have access to high-quality remote physiologic monitoring services to manage chronic conditions and help patients eliminate unnecessary hospital visits.”

U.S. Reps. David Kustoff (R-Tenn.), Mark Pocan (D-Wisc.), Troy Balderson (R-Ohio), and Don Davis (D-N.C.) introducing companion legislation in the House.

Rural Medicare patients face high rates of chronic conditions like heart failure, hypertension, and diabetes. In particular, Medicare patients living in rural areas have limited access to healthcare because of roadblocks like lack of transportation. Remote Physiologic Monitoring (RPM) helps patients manage chronic conditions and eliminates unnecessary hospital visits. A recent study of over 4,000 hypertension patients found that RPM decreased patients’ total monthly cost of care by more than 50%. Current lack of adequate Medicare reimbursement leads to not implementing RPM programs in rural areas, reducing access to cost-saving and patient-centered care.

Specifically, The Rural Patient Monitoring Access Act would ensure high-quality remote physiological monitoring services are established and maintained for Medicare beneficiaries in rural and underserved geographies; allow rural areas to provide RPM services at the national average rate; and decrease patients’ total monthly cost. Under the RPM Access Act:

• RPM providers must be capable of responding to data anomalies detected by the monitoring service;
• RPM providers must be capable of promptly transmitting captured vitals and treatment management notes to electronic health record of the supervising provider; and
• The Centers for Medicare & Medicaid Services may require providers of RPM to report data to the Secretary of Health and Human Services in order to facilitate the evaluation of cost savings generated to the Medicare program through the proliferation of remote physiologic monitoring services.

This legislation is supported by National Rural Health Association, American Association of Nurse Practitioners, HIMSS, American Telemedicine Association, Alliance for Connected Care, Ascension, LifePoint Health, Marshfield Clinic, SSM Health, the University of Virginia Center for Telehealth, and the Bipartisan Policy Center.

“Technology-enabled care is crucial to ensuring seniors in rural areas are able to safely manage their chronic conditions. Remote physiologic monitoring allows for chronic disease complications to be captured early – saving lives, reducing health care costs, and helping to mitigate common rural barriers such as longer distances to in-person treatment,” said Alan Morgan, CEO of National Rural Health Association.

“On behalf of HIMSS, we applaud Senators Blackburn and Warner, and Representatives Kustoff, Balderson, Pocan, and Davis for introducing the Rural Patient Monitoring (RPM) Access Act. Remote patient monitoring is a critical digital health tool that helps providers and patients work together to improve patient access and outcomes. We urge Congress to take action to advance the safe and effective use of RPM for millions of Medicare beneficiaries,” said Hal Wolf, President and CEO of HIMSS.

“Patients in rural and underserved communities deserve the same opportunity to manage their health as those in more resourced areas. At Lifepoint, we’ve seen firsthand how high-quality remote patient monitoring can help bridge long-standing access gaps and drive meaningful clinical improvement, especially for chronic conditions like hypertension and diabetes. This bill is an important step forward in ensuring fair reimbursement for rural providers, empowering them to deliver high-quality, proactive care to the patients who need it most,” said Dr. Chris Frost, Chief Medical Officer and Chief Quality Officer at Lifepoint Health.

“We are proud to support the Rural Patient Monitoring Access Act, which will help to ensure rural practitioners can provide remote physiologic monitoring services. RPM supports coordinated chronic disease management and acute and chronic disease risk reduction, while improving health outcomes helping patients remain healthy at home,” said Michael Richards, System Vice President at SSM Health.

“The Alliance for Connected Care applauds Senators Blackburn and Warner for their leadership to ensure rural patients have access to high-quality, innovative patient-centered care. Remote patient monitoring has a huge potential to empower rural seniors with technology to better take accountability for their own health,” said Chris Adamec, Executive Director of The Alliance for Connected Care.

“This proposed legislation will incentivize healthcare systems in rural areas to establish remote monitoring programs and ensure sustainability of existing programs. We are grateful for Sen. Warner and Sen. Blackburn’s leadership on this issue. Remote monitoring has been shown to improve outcomes and ultimately lower the cost of care,” said Karen Rheuban, MD, Director of the University of Virginia Center for Telehealth.

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WASHINGTON – Today, U.S. Sen. Mark R. Warner (D-VA), joined by U.S. Sens. Tim Kaine (D-VA), John Fetterman (D-PA), and Bernie Sanders (I-VT), wrote to Health and Human Services Secretary Robert F. Kennedy Jr. pushing back on his decision to gut the National Institute of Occupational Safety and Health (NIOSH), firing nearly 900 employees. Recent reporting has indicated that these firings include all employees tasked with protecting the health and safety of coal miners.

“According to reports, HHS is laying off approximately 873 employees, or two-thirds, of the National Institute for Occupational Safety and Health (NIOSH), part of the Centers for Disease Control and Prevention (CDC),” the senators wrote. “According to a notification provided to AFGE Local 1969, whose federal employee members are being impacted, all employees working on mining safety and health in NIOSH’s Spokane, WA and Pittsburgh, PA, offices are being let go. ,  The NIOSH Pittsburgh Mining Research Division focuses on coal miner safety, and the Spokane Mining Research Division specializes in hard rock mining, and are the two main research hubs for NIOSH’s Mining Research Program. Additionally, reports indicate more than 185 NIOSH employees are being laid off from its Morgantown, WV, office, who also work to protect miner health, among other occupational safety and health activities.”

The senators also highlighted the immediate impacts of this move, explaining that mining communities are already being left without key health services.

They continued, “We also have heard from those who work directly with our miner constituents in these communities that the Enhanced Coal Workers’ Health Surveillance Program is also being decimated. This program provides direct screening services via a mobile medical unit to miners at no cost. NIOSH also supports clinic sites where screening is done, so miners can understand if they are developing black lung or another condition and be as healthy as possible for themselves and their families.”

In their letter, the senators demanded answers from Secretary Kennedy, questioning how these crucial services will continue with a significantly reduced workforce. The senators requested a written response to the following:

1.  How many HHS employees who work in offices that work on mining health and safety have been fired, put on administrative leave, accepted the deferred resignation program offer, or accepted the VERA/VSIP offer since January 20, 2025? Provide a complete breakdown by agency and position. For each category of employee at each agency, provide information on GS level and veteran status, and clearly state the justification for termination. Include employees who have since been reinstated or placed on administrative leave, noting that change in status. Please provide the latest data available.
2. How many HHS employees remain who work on mining health and safety? Please provide a complete breakdown by agency and position.
3. How many additional employees who work in offices that work on mining health and safety do you intend to fire following the announcement made on March 27, 2025?
4. Provide all analyses conducted prior to the reorganization and firings of HHS employees who work in offices that focus on mining safety and health to determine the immediate and long-term impact these firings will have on programs and activities that those employees are tasked with administering. In particular, provide all analyses relating to 1) ensuring statutory obligations will be met, and 2) the Coal Workers’ Health Surveillance Program.

A copy of letter is available here and text is below.

Dear Secretary Kennedy:

We write today with alarming concern about reports that nearly the entire workforce that works to improve the health of miners was laid off and the office that oversees this work was eliminated. We urge you to reverse course immediately and ensure the Department of Health and Human Services (HHS) continues its important work in our states to protect and serve our constituents.

According to reports, HHS is laying off approximately 873 employees, or two-thirds, of the National Institute for Occupational Safety and Health (NIOSH), part of the Centers for Disease Control and Prevention (CDC).  According to a notification provided to AFGE Local 1969, whose federal employee members are being impacted, all employees working on mining safety and health in NIOSH’s Spokane, WA and Pittsburgh, PA, offices are being let go. ,  The NIOSH Pittsburgh Mining Research Division focuses on coal miner safety, and the Spokane Mining Research Division specializes in hard rock mining, and are the two main research hubs for NIOSH’s Mining Research Program. Additionally, reports indicate more than 185 NIOSH employees are being laid off from its Morgantown, WV, office, who also work to protect miner health, among other occupational safety and health activities. 

We also have heard from those who work directly with our miner constituents in these communities that the Enhanced Coal Workers’ Health Surveillance Program is also being decimated. This program provides direct screening services via a mobile medical unit to miners at no cost. NIOSH also supports clinic sites where screening is done, so miners can understand if they are developing black lung or another condition and be as healthy as possible for themselves and their families.

Never has there been a more critical time to do this work. A 2023 study conducted jointly by researchers at NIOSH and at the University of Illinois Chicago found that coal miners in central Appalachia—Virginia, West Virginia, and Kentucky—were eight times more likely to die from respiratory diseases like chronic obstructive pulmonary disease (COPD) and black lung than American men who are not miners.  Our constituents are getting more severe disease at younger ages in recent decades, and we might never had known that without the expertise of NIOSH’s work on coal miner health.

We require more than a fact sheet indicating these duties will be reorganized into an Administration for a Healthy America given the extensive cuts to personnel. In order for us to better understand how the same amount of work can be done with hundreds fewer individuals, please provide responses to the following questions by April 9, 2025:

1. How many HHS employees who work in offices that work on mining health and safety have been fired, put on administrative leave, accepted the deferred resignation program offer, or accepted the VERA/VSIP offer since January 20, 2025? Provide a complete breakdown by agency and position. For each category of employee at each agency, provide information on GS level and veteran status, and clearly state the justification for termination. Include employees who have since been reinstated or placed on administrative leave, noting that change in status. Please provide the latest data available.
2. How many HHS employees remain who work on mining health and safety? Please provide a complete breakdown by agency and position.
3. How many additional employees who work in offices that work on mining health and safety do you intend to fire following the announcement made on March 27, 2025?
4. Provide all analyses conducted prior to the reorganization and firings of HHS employees who work in offices that focus on mining safety and health to determine the immediate and long-term impact these firings will have on programs and activities that those employees are tasked with administering. In particular, provide all analyses relating to 1) ensuring statutory obligations will be met, and 2) the Coal Workers’ Health Surveillance Program.

Art Miller, an expert in mine air quality who has been working for NIOSH since 1996 and for its predecessor before this, was part of the Spokane-area firings. He noted that no one else does this kind of research and that “every worker in this country deserves to go home safe.”  We agree, and urge you to reverse these cuts before it’s too late.

Sincerely,

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