Two bills aimed at reforming the prior authorization process in California health care have passed both houses of the state legislature and are now awaiting the Governor’s signature. The legislation, sponsored by the California Medical Association (CMA), seeks to reduce administrative hurdles that impact patient access to timely medical care.
Prior authorization requires doctors to obtain approval from health plans before providing certain treatments or medications. Critics argue that this process can delay necessary care and create significant administrative work for physicians, sometimes resulting in severe health outcomes for patients.
Assembly Bill 512 (AB 512), authored by Assemblymember John Harabedian, would require electronic prior authorization requests to be answered within three business days for standard cases and within 24 hours for urgent cases. Non-electronic requests would need a response within five business days for standard reviews and 48 hours for urgent matters.
Senate Bill 306 (SB 306), authored by Senator Josh Becker, proposes eliminating redundant prior authorizations for routine care and introducing new transparency requirements. Under SB 306, the California Department of Managed Health Care could waive prior authorization requirements if insurers approve certain services or prescriptions at least 90% of the time. Additionally, health plans would be required to report data on their prior authorization decisions.
Both bills received strong support in the legislature. SB 306 passed with a vote of 76-1 in the Assembly and unanimously in the Senate. AB 512 was approved by a vote of 30-0 in the Senate and 67-2 in the Assembly.
“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 legislative progress to physician-led grassroots advocacy efforts across California. The association is now urging swift action from the Governor to sign both bills into law.
