A Clock... Finally.

If you've spent any time running a DME operation, you already know the drill. You submit a prior authorization request. You wait. You follow up. You wait some more. Meanwhile, a patient who needs a power wheelchair, oxygen concentrator, or CPAP device is sitting at home without it.

That wait isn't just frustrating, but it has real consequences for patients and for your business.

So when AAHomecare formally endorsed the Medicare Advantage Improvement Act of 2026 on June 18th, it was the kind of news the HME industry has been pushing for for years. The bipartisan bill (H.R. 8375 & S. 4384) would require Medicare Advantage plans to respond to standard prior authorization requests within 72 hours and expedited requests within 24 hours.

It's a big deal. Here's why it matters, and what it means for how you run your operation right now.

What the Bill Actually Does

The Medicare Advantage Improvement Act of 2026 goes beyond just putting a clock on prior auth decisions. Key provisions include:

• 72-hour response requirement for standard prior authorization requests
• 24-hour response requirement for expedited requests
• Coverage criteria alignment — Medicare Advantage plans would be prohibited from using criteria more restrictive than traditional Medicare
• Increased transparency and claims integrity requirements for MA plans

The legislation has broad support from provider groups, including AAHomecare, which called it "a major step forward for patients and the home medical equipment providers who serve them."

Why This Matters for DME Providers Specifically

Medicare Advantage now covers more than half of all Medicare-eligible beneficiaries. That means prior authorization bottlenecks in MA plans aren't an edge case, but a daily reality for most DME suppliers.

The downstream effects are real:

• Cash flow disruption from delayed approvals holding up delivery and billing
• Staff time consumed tracking, following up, and resubmitting requests
• Patient dissatisfaction when equipment doesn't arrive when expected
• Lost orders when patients or referral sources give up and go elsewhere

For providers operating on thin margins, these aren't minor inconveniences. They are operational drains that compound over time.

The Honest Take: Reform Is Welcome, but Not a Full Solution

We're rooting for this bill, but passing legislation is one thing — implementation is another. Even if the 72-hour clock becomes law, prior authorization will still exist. Requests will still need to be documented, submitted, and tracked. The administrative burden doesn't disappear; it just gets a deadline.

That's exactly why having software that handles prior auth workflows efficiently isn't a nice-to-have — it's a competitive necessity.

Providers who have already invested in streamlined documentation and submission processes will be positioned to take full advantage of faster response times when the law takes effect. Those who are still managing prior auth through spreadsheets, faxes, or disconnected systems will still be fighting uphill — just with a slightly shorter timeline.

What You Should Be Doing Now

Regardless of whether the bill passes this session, here are three things every DME provider should evaluate:

1. Audit your prior auth workflow. How many staff hours per week go into tracking authorization status? Where do requests fall through the cracks?
2. Know your approval rate. Under current CMS rules, providers with a 90%+ claim approval rate may qualify for prior authorization exemptions on certain items. Do you know where you stand?
3. Make sure your software is working for you, not against you. If your team is manually entering the same data in multiple systems, chasing down documentation that should already be attached, or missing deadlines because nothing is automated — that's a software problem, not a people problem.

The Bottom Line

The Medicare Advantage Improvement Act of 2026 is a signal that the industry's frustration with prior auth delays has finally reached a tipping point. DME providers have been saying for years that these bottlenecks harm patients and operators alike — and lawmakers are starting to listen.

At Curasev, we've built our platform around the reality that DME operations are complex, compliance-heavy, and constantly evolving. Prior auth reform — whether it comes through legislation, CMS rule changes, or technology — is something we're actively building toward alongside our customers.

Because at the end of the day, faster approvals mean faster deliveries. And faster deliveries mean patients getting the equipment they actually need.

Want to talk through how Curasev handles prior auth workflows? Reach out to our team.