Doctor Knows Best Act of 2025
Doctor Knows Best Act of 2025
Plain Language Summary
# Doctor Knows Best Act of 2025 - Plain Language Summary **What the Bill Does:** This bill would eliminate "prior authorization" requirements and similar insurance approval processes for all health insurance plans, including Medicare and Medicaid. Currently, insurance companies often require doctors to get permission before providing certain treatments or procedures—a process called prior authorization. This bill would ban that practice, allowing doctors to prescribe treatments immediately without waiting for insurance company approval.
The changes would take effect for insurance plans starting on January 1, 2026. **Who It Affects:** The bill would impact all Americans with health insurance—whether through private plans, Medicare, Medicaid, or other federal programs. It would also affect insurance companies, hospitals, and doctors' offices, which currently spend significant time on the authorization paperwork process. **Current Status:** The bill is currently in committee in the House of Representatives and has not yet been voted on. It was introduced by Representative Jefferson Van Drew (R-NJ).
CRS Official Summary
Doctor Knows Best Act of 2025This bill prohibits health insurance plans (including federal health care programs) from imposing a prior authorization requirement, utilization management technique (e.g., step therapy or fail-first protocol), or medical necessity review for any item or service for which benefits are available under the plan.The prohibition is effective for plan years beginning on or after January 1, 2026.
Latest Action
Referred to the Committee on Energy and Commerce, and in addition to the Committee on Oversight and Government Reform, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.