Urge Your Member of Congress to Reduce Administrative Burden and Increase Price Transparency in Healthcare



PA-ACP is joining with the ACP to call on its members to join us in a "Write to Congress" campaign to urge lawmakers to act on important legislation that will increase price transparency by health care organizations and reduce administrative burden for physicians and their patients.

Pending legislation in the US House, H.R. 5378, the Lower Costs, More Transparency Act, (“the Act”), would provide greater transparency regarding the cost of health care by requiring health insurers, hospitals, and pharmacy benefit managers (PBMs) to be transparent about the prices they charge patients. It would also require Medicare Advantage Organizations (MAOs) to report on financial interests in hospitals or health facility ownership, allowing data to be collected on the effect of consolidation in health care delivery that drives up costs. H.R. 5378 would also reauthorize and provide funding for the National Health Service Corps, Community Health Centers, and the Teaching Health Center Graduate Medical Education program.

However, this legislation is missing important provisions that would provide critical reforms to prior authorization and step therapy requirements. Your help is needed to ensure these important reforms are included in this or any other health care legislative package that Congress votes on this year.

Thanks to PA-ACP’s leadership, Pennsylvania patients will soon be subject to fewer delays in treatment because of restrictive prior authorization procedures. But nationally, many patients in Medicare Advantage plans are subject to delays; other patients who are in group health insurance plans are required to fail first on the plans’ prescription drugs before the clinically recommended drug can be dispensed. The ACP is asking members to help by urging Congress to include the Improving Seniors Timely Access to Care Act and the Safe Step Act, in the Lower Costs, More Transparency Act, H.R. 5378, or any other legislative package addressing access to care and health care costs, or passing them as standalone legislation.

Background: ACP is encouraged by Congress working to improve access to and affordability of health care for patients. Reforming prior authorization and step therapy processes must be included in this effort.

The Improving Seniors Timely Access to Care Act has been an ACP priority for several years but has not yet been reintroduced this year. It would streamline prior authorization processes for Medicare Advantage plans. The Safe Step Act, H.R. 2630/S. 652, is one of the bills that ACP members advocated during Leadership Day this year and would require group health plans to provide an exception process for any medication step therapy protocol to help ensure that patients can safely and efficiently access treatment.

Take Action: Please send a letter to your members of Congress expressing the need to act on these important priorities. A sample email message to members of Congress has been provided for you that contains blank fields for you to personalize. Simply click on the “Take Action” link below, follow the prompts, and submit your letters electronically.