August Recess, September Sprint: Prior Authorization Reform Nears a Decisive Moment

Congress has left Washington for its traditional August recess, but the work of legislating - and advocating - has not stopped.

The House and Senate are spending much of August away from the Capitol, with lawmakers returning to their states and congressional districts. Although commonly called a “recess,” this period is officially designated for district and state work. Members use the time to meet with constituents, visit local organizations and, most importantly to them, connect with the electorate before the polls open in November.

The House is scheduled to return for votes beginning August 31, while the Senate’s state work period extends into September. They’ll adjourn again for the entire month of October. After Election Day, Congress could return for a “lame-duck” session, but the agenda will be crowded and the outcome of individual bills will be less predictable.

For the heart rhythm community, one measure is particularly well positioned for action: the Improving Seniors’ Timely Access to Care Act of 2025.

Unanimous progress in the House

The legislation (H.R. 3514 in the House and S. 1816 in the Senate) would modernize and improve the use of prior authorization by Medicare Advantage plans. The proposal has reached Congress before, but this summer brought significant new momentum. On July 15, the House Ways and Means Committee approved H.R. 3514 by a unanimous vote of 42–0. Less than a week later, the House Energy and Commerce Committee (the other committee with jurisdiction over the legislation) advanced it by another unanimous vote, 45–0.

Those votes cleared an important procedural hurdle and demonstrated that prior authorization reform remains one of the few health policy issues capable of attracting overwhelming support from both parties. As of July 21, the legislation had nearly 300 House cosponsors and more than 70 Senate cosponsors, along with the endorsement of more than 300 patient and health care organizations. The next step is consideration by the full House.

What the legislation would do

For patients, prior authorization can mean waiting days or weeks for approval of care that their physician has already determined is medically necessary. For clinicians and their teams, the process consumes staff time, requires repeated follow-up and can disrupt carefully planned treatment.

These delays are especially concerning in heart rhythm care, where timely access to diagnostic testing, medications, procedures and follow-up services can be essential to preventing disease progression and avoiding hospitalization.

The Improving Seniors’ Timely Access to Care Act would not eliminate prior authorization. Instead, it would establish clearer and more accountable rules for how Medicare Advantage plans use it. Among its principal provisions, the legislation would:

• Require plans to establish an electronic prior authorization process;

• Create a pathway for real-time decisions on routinely approved services;

• Require plans to explain their prior authorization requirements, documentation standards and decision criteria more clearly;

• Direct plans to review their requirements regularly and eliminate those that are no longer justified;

• Require greater public reporting of approval, denial and appeal data at the individual plan level; and

• Strengthen federal oversight of how prior authorization affects beneficiaries and health care providers.

Together, these reforms would make the process more transparent, reduce unnecessary administrative work and help patients receive medically necessary care without avoidable delays.

A narrow path before the election

Despite its broad support, passage is not guaranteed. Congress will return to Washington facing a crowded agenda and limited floor time. Government funding, defense policy and other must-pass measures will compete with health care legislation for attention.

The most direct path would be for House leaders to bring H.R. 3514 to the floor during the September session. Its extensive bipartisan cosponsorship and unanimous committee votes could make it a candidate for expedited consideration. The Senate would then need to act on S. 1816 or take up the House-passed legislation.

If Congress does not complete the bill before leaving for the campaign season, supporters could seek its inclusion in a larger health care or year-end legislative package during the post-election session. That route remains possible, but history shows that even broadly supported health policies can fall away as final packages are negotiated.

Recess is an advocacy opportunity

The August recess therefore arrives at an important moment. With lawmakers home, physicians, patients and other advocates have an opportunity to explain how prior authorization delays affect care in their own communities.

Meetings do not have to occur in Washington to be effective. A conversation at a district office, a facility visit, a local event or a brief message sharing a specific patient-care example can reinforce the need for action. Advocates should encourage House members to support floor consideration of H.R. 3514 and ask senators to help move S. 1816 before the end of the year.

Congress has already demonstrated that bipartisan agreement on prior authorization reform is possible. When lawmakers return to Washington, the question will be whether they can convert that agreement into final action. With only a few legislative weeks remaining before the election, the time to finish the job is now.