Physicians across California continue to face a growing burden: excessive prior authorization requirements that delay care, undermine medical decision-making and prioritize profits over patients.

Health plans have increasingly weaponized prior authorization as a cost-containment tool, creating a system where red tape, denials, and delays often come at the expense of patient health and physician autonomy. Nearly one in four physicians (24%) report that prior authorization has directly led to serious adverse outcomes—including hospitalization, permanent harm, or even death.

Meanwhile, physicians and their teams are bogged down by paperwork rather than spending time with patients. On average, medical practices complete 43 prior authorizations per week, consuming nearly two full workdays to comply with requirements that rarely improve outcomes.

The Solution: CMA’s Prior Authorization Reform Package

The California Medical Association (CMA) is advancing a legislative package to restore common sense to patient care by streamlining prior authorization processes, reducing administrative burdens, and ensuring timely access to care.

Here’s what’s included:

• AB 510 (Addis): Specialty-Specific Peer Review

Requires a physician in the same or similar specialty to review denials, ensuring that peers who understand the recommended treatment’s clinical context evaluate appeals.

• AB 539 (Schiavo): Extended Prior Authorization Validity

Extends approved prior authorizations to one year (up from the current 60–90 days), reducing repeated paperwork and offering patients continuity of care without unnecessary delays.

• AB 512 (Harabedian): Faster Response Times

Shortens required health plan response times to 24 hours for urgent requests and 48 hours for non-urgent cases. The current standard—72 hours and five days, respectively—leaves too many patients waiting.

• SB 306 (Becker): Eliminate Low-Value Authorizations

Removes prior authorization requirements for any service approved over 90% of the time, minimizing unnecessary barriers to care and freeing up physicians to do what they do best—care for patients.

CMA actively advocates for these reforms in Sacramento, and your voice matters. These bills are common-sense steps to reduce administrative fatigue, support clinical judgment, and protect patient outcomes.