Two bills sponsored by the California Medical Association (CMA) that seek to reform the prior authorization process in health care have passed both houses of the California state legislature and are now awaiting the Governor’s signature.
Prior authorization is a process that requires doctors to obtain approval from health plans before providing certain treatments or services. Critics argue that this system creates administrative burdens for physicians and can delay patient care, sometimes resulting in severe health outcomes.
Assembly Bill 512 and Senate Bill 306 are designed to streamline this process. AB 512, authored by Assemblymember John Harabedian, would require health plans to respond to electronic prior authorization requests within three business days for standard cases and within 24 hours for urgent care. For non-electronic requests, responses would be required within five business days for standard reviews and 48 hours for urgent requests.
Senate Bill 306, authored by Senator Josh Becker, would allow the California Department of Managed Health Care to waive prior authorization requirements for services or prescriptions that insurers approve at least 90% of the time. The bill also includes new transparency measures requiring health plans to report data on prior authorizations.
“On behalf of California’s physicians and patients, CMA applauds the Legislature for advancing thoughtful reforms that reduce bureaucratic red tape and put patients first,” said CMA President Shannon Udovic-Constant, M.D. “Together, AB 512 and SB 306 will help ensure that medical decisions are timely, data-driven, and rooted in clinical expertise – not paperwork or unnecessary delays. CMA thanks Assemblymember Harabedian and Senator Becker for their leadership in accelerating access to care.”
SB 306 received broad support with a vote of 76 AYE votes and one NO vote in the Assembly; it passed unanimously in the Senate. AB 512 passed with a Senate vote of 30-0 and an Assembly vote of 67-2. CMA attributed this legislative success in part to physician-led grassroots advocacy efforts.
Both bills now await action from the Governor. CMA has called for swift signing to address delays in patient care caused by current prior authorization practices.
