June 29, 2022
A California Medical Association (CMA) bill to reduce prior authorization red tape has passed out of the Assembly Health Committee. This bill—SB 250 authored by Senator Richard Pan, M.D.—will allow physicians to spend less time on paperwork and billing and will allow patients to get the care they need without unnecessary delays.
SB 250 would require health plans to exempt physicians from prior authorization rules if they have practiced within the plan's criteria 80% of the time. All other physicians will have the right under the bill for a prior authorization appeal to be conducted by a physician in the same or similar specialty.
“Insurance company prior authorization red tape creates serious and dangerous delays in care for many California patients,” says CMA President Robert E. Wailes, M.D. “We thank the Assembly Health Committee for passing SB 250 and bringing us one step closer to streamlining prior authorization requirements and minimizing delays or disruptions so that patients get the care they need when they need it.”
The bill now heads to the Assembly Appropriations Committee.
Share Your Prior Authorization Stories
CMA is asking you to share your unique experience as a patient, physician or health care professional so that we can demonstrate to lawmakers how prior authorization policies are harming patients.
If you have waited days or months for an insurance company to approve a medicine prescribed by your doctor, we want to hear from you. If you are a physician frustrated with the administrative headaches and their impact on your patient, we want to know your story.
Click here to share your prior authorization stories.