Medicare patients would get prior authorization decisions from doctors, not just administrators.
This bill would make sure that doctors, not just insurance administrators, decide if a Medicare patient's medical care needs prior approval. It would require Medicare plans to use clear, evidence-based rules for these decisions, which could help patients get needed care faster.
Today, companies managing Medicare plans can make prior authorization decisions without a doctor's direct review, and the rules they use might not always be clear or based on strong medical evidence. If this bill becomes law, all prior authorization and denial decisions for Medicare patients would have to be made by a qualified doctor, following transparent, evidence-based clinical guidelines that are publicly available and updated at least annually.
HR 2433 · 119th Congress · AI Summary by gemini-2.5-flash · 8/10
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38 filings mentioned this bill
Amounts reflect total quarterly lobbying spend reported to the Senate, not bill-specific spending. Source: Senate LDA filings.