April 11, 2025 – MedLegalNews – SACRAMENTO, CA — Prior Authorization Delays: A group of California lawmakers, backed by the California Medical Association (CMA) and physicians statewide, has introduced a legislative package to overhaul the state’s prior authorization process. The goal: to reduce delays and improve access to timely, medically necessary care.
“When people have health insurance, they expect access to care—not hurdles,” said CMA President Shannon Udovic-Constant, M.D. “This legislation puts patients first by removing the bureaucratic barriers that delay essential treatment.”
What’s in the Prioritizing Patients, Empowering Physicians Package?
Prior Authorization Delays: The legislative package includes SB 306, AB 510, AB 539, and AB 512. Each bill targets a specific cause of delay in the prior authorization process, aiming to reduce administrative burdens and improve patient outcomes.
SB 306: Eliminate Unnecessary Authorizations
Senator Josh Becker (SD 13) authored SB 306, which would remove prior authorization requirements for services already approved more than 90% of the time.
“This bill cuts through redundant paperwork,” Becker said. “It allows physicians to focus on patient care rather than spend hours on approvals that insurers usually grant anyway.”
AB 510: Require Peer-Level Appeals
Assemblymember Dawn Addis (AD 30) introduced AB 510 to ensure appeals are reviewed by physicians with similar specialties. That way, decisions reflect a clear understanding of the patient’s condition.
“Care decisions should come from someone who understands the complexity of the case,” Addis noted. “This bill brings fairness and transparency to appeals.”
AB 539: Extend Authorization Periods
Assemblymember Pilar Schiavo (AD 40) proposed AB 539, which would extend prior authorization approvals to one year. Currently, many expire in 60–90 days, forcing patients to restart the process.
“Patients with chronic conditions shouldn’t have to fight for care they’ve already been approved for,” Schiavo said. “Our bill will eliminate repetitive paperwork and protect continuity of care.”
AB 512: Speed Up Approval Timelines
Assemblymember John Harabedian (AD 41) introduced AB 512 to shorten response times. Health plans would have just 24 hours to respond to urgent requests and 48 hours for non-urgent ones—down from the current limits of 72 hours and five business days.
“Timely care saves lives,” Harabedian explained. “This bill ensures that patients aren’t waiting days to receive essential treatment.”
Why This Package Matters
Together, these bills could dramatically reduce delays that put patient health at risk. According to CMA, prior authorization—originally intended to control costs—has evolved into a system that often causes harm.
Physicians say they spend too much time on administrative work, while patients suffer from postponed treatments, unnecessary hospitalizations, and worsening health outcomes. This package aims to shift the system back toward patient-centered care.
Looking Forward
CMA and supporting lawmakers view these bills as essential to fixing what many see as a broken system. As the 2025 legislative session progresses, they urge public support to ensure timely, compassionate care becomes a standard—not an exception.
Stay updated on this legislative package and other key developments in California medical policy by visiting MedLegalNews.com.
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