In late March, Representatives Mark Green, MD, (R, Tenn.) and Kim Schrier, MD, (D-Wash.) reintroduced H.R. 2433, the Reducing Medically Unnecessary Delays in Care Act of 2025. The bill calls for additional transparency in prior authorization determinations, and would also require that Medicare, Medicare Advantage and Medicare Part D plans make decisions based on medical necessity and written clinical criteria.
Nevada lawmakers are discussing nearly 10 bills aimed at reforming prior authorization requests for medical care through requiring quicker response times, increasing transparency, and creating regulations for artificial intelligence in decision-making.
Some of Florida’s most vulnerable people who rely on Medicaid may wind up having their care flow through managed care organizations under a bill the Legislature passed this session.
As the state legislative session comes to a close, Springfield state Rep. Melanie Stinnett is holding out hope that the Missouri General Assembly will come to an agreement on legislation limiting prior authorization for health care services.
In practice, the 340B Drug Pricing Program has become a financial advantage for large health systems and pharmacy benefit managers (PBMs) – third-party administrators who manage prescription drug programs for insurers and employers.