Congressman proposes banning prior authorization across all health plans
A U.S. congressman wants to ban prior authorization across all health plans, labeling the healthcare utilization-management practice as “useless red tape.”
Rep. Jeff Van Drew, R-N.J., proposed the Doctor Knows Best Act of 2025 last month in the U.S. House. The bill would prohibit any group health plans, insurance issuers and federal healthcare programs from applying prior authorization requirements, medical necessity reviews and any other tactics to control care delivery.
“People shouldn’t have to wait around for an insurance company to decide if they can get the care their doctor already said they need,” Van Drew said in a statement shared with Radiology Business. “Prior authorization is just unnecessary red tape that delays treatment and puts insurance companies in charge instead of doctors. My bill gets rid of it, plain and simple—because medical decisions should be made in the doctor’s office, not a corporate office."
If approved, the bill would take effect Jan. 1, 2026. Van Drew also previously proposed the Doctor Knows Best Act in 2023, but it failed to pass. AHIP, the country’s largest lobbying group for insurers, did not respond to a request for comment.
The proposal comes amid growing concern among patients, politicians and providers about health plans’ use of prior authorization. Radiology faces the third heaviest burden from PA in Medicare Advantage, one recent study found. These utilization-management tactics can lead to care delays, anxiety and administrative burden for cancer patients, another analysis determined.
Last year, the American College of Radiology told Congress it believes PA is a big part of the mounting administrative load physician practices face.
“The ACR has long supported congressional and regulatory efforts to reduce physician administrative burden across all payment systems,” the college said in written testimony submitted to a key Senate committee. “Prior authorization, which is frequently required by health plans prior to a patient receiving services such as advanced imaging recommended by their physician, is a major contributor to this burden.”
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.