The president of California Medical Association (CMA), state legislators and dozens of physicians unveiled the Prioritizing Patients, Empowering Physicians bill package, a suite of legislation aimed at cutting red tape in the health care system and ensuring patients receive timely, medically necessary care.

“When people have health insurance, they expect to be able to get the health care they need when they need it,” said CMA President Shannon Udovic-Constant, M.D. “But too often, bureaucratic delays get in the way, forcing patients to wait for essential treatments while their physicians navigate unnecessary bureaucratic hurdles. This legislative package will put patients first, allowing doctors to focus on providing all our patients the best possible care.”

The package, which is sponsored by CMA and includes AB 510, AB 539, AB 512, and SB 306, addresses the burdensome prior authorization process that often delays patient care and, in some cases, leads to severe health consequences, including permanent bodily damage, hospitalizations, and even death. The proposed reforms would reduce the volume of prior authorization requests, expedite approvals, extend authorization validity, and ensure that appeals are reviewed by qualified specialists.

SB 306 by Senator Josh Becker (SD 13) requires health plans to remove the requirement for prior authorization from any service that they approve more than 90% of the time. This will reduce the overall volume of prior authorization requests and ensure that patients can receive the care they need with minimal delay and physicians can spend more time focusing on patient care.

“Doctors should be treating patients – not spending hours buried in paperwork that needlessly delays access to treatment. SB 306 cuts through the red tape to accelerate approval of services that are almost always approved anyway,” said Senator Becker. “It’s a simple, data-driven solution that will reduce delays in care, free up providers to do their jobs, and help patients get the timely treatment they need. This bill is about restoring common sense and compassion to our healthcare system.” 

AB 510 by Assemblymember Dawn Addis (AD 30) requires that appeals of prior authorization denials be performed by a provider of the same or similar specialty. This will help ensure that providers can discuss prior authorization denials with a professional peer who understands the recommended treatment and underlying condition.

“It’s vital that health care decisions must be made by professionals who understand the complexities of a patient’s condition,” said Assemblymember Addis. “AB 510 is critical to protecting patient rights and ensuring access to a fair, transparent process that prioritizes health over profits.”

AB 539 by Assemblymember Pilar Schiavo (AD 40) extends the validity of an approved prior authorization to one year (current industry standard is 60 to 90 days). This will provide patients with a longer window of time to receive medically necessary care and avoid the cumbersome prior authorization review and appeal processes.

 “People with often chronic health conditions should not have to argue with their insurance company every couple months just to continue their already approved treatment. Our bill - The Timely Care Act (AB 539) - will cut the red tape that often delays care so people can focus on their health, not on paperwork,” said Assemblymember Schiavo. “As someone who spent over a decade fighting for patients as a nurse advocate, I know how critical timely care is, and how much time is wasted by doctors having to spend time on paperwork rather than caring for patients. Reducing barriers to medically necessary care for both patients and physicians will make a real difference in people’s lives.”

AB 512 by Assemblymember John Harabedian (AD 41) requires health plans to respond to urgent prior authorization requests within 24 hours and respond to nonurgent requests within 48 hours. Currently, health plans have 72 hours for urgent requests and five days for nonurgent requests. This change will ensure more patients can receive care or appeal denials in a timely fashion. 

“AB 512 is a crucial step toward improving patient access to timely care,” said Assemblymember Harabedian. “By shortening response times for both urgent and nonurgent prior authorization requests, we are ensuring that patients can receive the care they need when they need it most. This bill represents a dedication to putting patient well-being at the forefront of our healthcare system.”

CMA thanks its partners in the legislature for championing reforms to our broken prior authorization system. The Prioritizing Patients, Empowering Physicians bills are part of CMA’s sponsored bill package for the 2025 legislative session.