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Prior authorization reform effort is revived and ready for action in early 2024

September 20, 2023


Building on the efforts, success and progress made during the 2023 legislative year, CMA’s sponsored bill to reform the prior authorization process has become a two-year bill, which will allow it to be heard next year when the Legislature reconvenes.

Prior authorization legislation authored by Senator Nancy Skinner to ensure patients get treatments they urgently need without unnecessary delays, was revived at the end of the legislative year to allow for CMA to continue to craft a policy that will reduce prior authorization burdens, decrease treatment delays and improve patient outcomes.

Senate Bill (SB) 598, CMA’s sponsored bill this year to reform the prior authorization system, passed several legislative hurdles, but it was held on the suspense file in the Assembly Appropriations Committee in early September.

However, CMA was able to amend language from SB 598 into SB 516, allowing the prior authorization reform effort to resume when the Legislature reconvenes for the second year of the two-year session. On its current track, the bill needs to pass to pass the Assembly Appropriations Committee, then the full Assembly and then it must go back to the Senate for final passage. 

“CMA members and patients advocating for change have been vital in ensuring that prior authorization reform legislation can continue its path forward, and we continue to need your support to help make this bill become law,” said CMA President Donaldo Hernandez, M.D. “California is joined by dozens of states that have recognized the need for reform and introduced legislation to fix the broken prior authorization system.”

Senator Scott Wiener and Assemblymembers Corey Jackson, Jasmeet Bains, M.D. and Akilah Weber, M.D., have signed on as co-authors of SB 516.

CMA physicians have staunchly advocated for prior authorization reform by sharing personal stories and stories from patients about harmful care delays and denials; speaking to local media about the need for prior authorization reform; and submitting video testimonies about the impact of prior authorization. Patient witnesses also shared harrowing testimony in legislative hearings and through media outlets about the devastating impacts prior authorization delays have had on their lives and their loved ones.

When the Legislature reconvenes, we will need your help more than ever to ensure SB 516 makes it to the Governor’s desk. We urge physicians to continue to share stories about the harms of prior authorization delays – both from your own experiences and practices, as well as from your patients. These personal stories demonstrate the human toll of care delays and denials and can help make prior authorization reform a reality.

As the next legislative session approaches, be on the lookout for updates and further communications regarding SB 516. Together, we can win this fight and create a better system that prioritizes patients over profits.

 

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