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What DMEPOS Providers Need to Know About H.R. 3514: Improving Seniors' Timely Access to Care Act

Published in VGM Government Relations on July 20, 2026

Medicare Advantage prior authorization continues to be one of the most significant operational and patient care challenges facing DMEPOS suppliers. A new bipartisan bill, H.R. 3514: Improving Seniors' Timely Access to Care Act, seeks to increase transparency, accountability, and oversight of Medicare Advantage prior authorization practices. This bill passed out of Ways & Means markup by a unanimous vote (42-0) on July 15. While the legislation does not eliminate prior authorization requirements, it could provide important tools to identify and address payer behavior that delays patient access to medically necessary equipment.  

Why This Matters 

DMEPOS suppliers routinely encounter delays, denials, and administrative burdens associated with Medicare Advantage prior authorization requirements. These obstacles can postpone access to critical items such as oxygen equipment, wheelchairs, PAP devices, enteral nutrition, prosthetics, and other medically necessary products. 

H.R. 3514 focuses on making Medicare Advantage plans more transparent about how they administer prior authorization and how quickly they respond to requests and appeals. The bill would require plans to publicly report performance data, allowing providers, patients, policymakers, and regulators to better understand how individual plans are managing authorization requests.  

Key Provisions for DMEPOS Suppliers 

Increased Transparency 

The legislation would require Medicare Advantage plans to report detailed prior authorization information, including: 
  • Approval and denial rates. 
  • Appeal rates and outcomes. 
  • Average and median time required to resolve appeals. 
  • Data separated between expedited and standard authorization requests. 
  • Information reported at the individual plan level.  

For suppliers, this means there will be objective data showing how plans perform when processing prior authorization requests. 

Greater Accountability 

For years, suppliers have shared stories about delayed approvals and inappropriate denials. This legislation would move the discussion beyond anecdotes by requiring plans to publish measurable performance metrics. Plans with unusually high denial rates or lengthy response times could face increased scrutiny from CMS, Congress, providers, and beneficiaries.  

Potential for Faster Decisions 

The legislation directs CMS to establish timeliness standards for prior authorization determinations and specifically allows for timelines of seven days or less when deemed practicable by the Secretary.  

For patients awaiting medically necessary equipment, even modest reductions in authorization delays could improve outcomes and accelerate access to care. 

More Stakeholder Input 

The bill expands stakeholder engagement by requiring input from physicians and other stakeholders, including providers and suppliers participating in Medicare Advantage networks. This creates new opportunities for the DMEPOS community to highlight operational challenges and patient access issues associated with current authorization practices.  

What the Bill Does Not Do 

While the legislation represents a positive step, members should understand its limitations. 

The bill: 

  • Does not eliminate prior authorization requirements. 
  • Does not establish "gold carding" exemptions for high-performing suppliers. 
  • Does not address Medicare Advantage network adequacy concerns. 
  • Does not require Medicare Advantage plans to align all utilization management practices with traditional Medicare coverage rules.  

As a result, many of the administrative burdens suppliers experience today would remain in place. 

Long-Term Significance 

Perhaps the most important aspect of H.R. 3514 is that it creates a framework for collecting and publishing data that can support future reform efforts. If the reporting requirements reveal excessive denial rates, lengthy delays, or patterns of inappropriate utilization management, policymakers will have stronger evidence to pursue additional changes. 

That data could eventually support future initiatives such as: 

  • Prior authorization reform. 
  • Gold carding programs. 
  • Stronger oversight of Medicare Advantage plans. 
  • Improved DMEPOS network adequacy standards. 
  • Greater alignment between Medicare Advantage and traditional Medicare coverage policies. 

What Members Can Do Now 

Members should continue documenting: 

  • Prior authorization delays. 
  • Denials later overturned on appeal. 
  • Patient care disruptions. 
  • Administrative costs associated with Medicare Advantage utilization management. 

Real-world examples, combined with the new transparency measures proposed in H.R. 3514, can help demonstrate the need for additional reforms that protect beneficiary access to medically necessary DMEPOS services. 

Bottom Line 

H.R. 3514 will not solve every Medicare Advantage prior authorization challenge facing DMEPOS suppliers. However, it represents a meaningful step toward greater transparency, accountability, and oversight. By shining a light on how Medicare Advantage plans process authorization requests, the bill could help build the case for future reforms that improve patient access and reduce unnecessary administrative burdens on providers.  

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