Reducing Medically Unnecessary Delays in Care Act of 2025

# Reducing Medically Unnecessary Delays in Care Act of 2025 **What the Bill Would Do** This bill would require Medicare (the federal health insurance program for seniors and some disabled individuals) to base all coverage decisions on written clinical criteria developed with input from physicians. Specifically, it would apply to decisions about prior authorization (when insurers require approval before covering a treatment) and denials of coverage. The goal is to establish clear, doctor-informed standards that Medicare must follow when deciding whether to pay for medical services. **Who It Affects and Key Provisions** The bill primarily affects Medicare beneficiaries who may face delays waiting for coverage approval, as well as doctors and healthcare providers who must navigate Medicare's approval process.

It also impacts Medicare itself, which would need to develop transparent clinical criteria in consultation with physicians rather than making coverage decisions on other bases. The bill targets what sponsors view as "medically unnecessary delays"—situations where patients wait for approvals that may ultimately be granted anyway. **Current Status** The bill is currently in committee (HR 2433, 119th Congress) and has not yet been voted on by the full House. It was introduced by Representative Mark Green (R-Tennessee).