Two bills sponsored by the California Medical Association (CMA) aimed at reforming the prior authorization process have passed both chambers of the California legislature and are now awaiting the Governor’s signature.
The current prior authorization system requires physicians to secure approval from health plans before providing certain treatments, which has led to administrative burdens and delays in patient care. These delays have resulted in severe health outcomes, including hospitalizations and life-threatening events.
Assembly Bill 512, authored by Assemblymember John Harabedian, proposes new timelines for health plan responses to prior authorization requests. Under this bill, electronic requests must be answered within three business days for standard cases and within 24 hours for urgent care. Non-electronic requests would require a response within five business days for standard reviews and 48 hours for urgent requests.
Senate Bill 306, introduced by Senator Josh Becker, seeks to eliminate redundant prior authorizations for routine care. The bill also includes transparency measures such as requiring health plans to report data on prior authorizations and allowing the California Department of Managed Health Care to waive requirements for services or prescriptions approved at least 90% of the time.
Both bills received strong legislative support. SB 306 was approved with 76 AYE votes and one NO vote in the Assembly and passed unanimously in the Senate. AB 512 cleared the Senate with a 30-0 vote and passed in the Assembly with a vote of 67-2.
“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.”
CMA attributes much of this progress to physician-led grassroots advocacy efforts. The organization is now calling on the Governor to sign both bills into law to improve access to timely medical care across California.
