February 2026 President’s Message
MSSC working to secure prior-authorization relief
by Chady Sarraf, MD —
As an MSSC survey last month showed, prior authorization remains a major challenge and frustration. In addition to the costs and time it im- poses on our practices, delays and denials often result in postponed diagnoses, interrupted treatment plans and unnecessary stress and suffering for patients. In some cases, they lead to worsened health outcomes, emergency department visits or hospitalizations that could have been avoided with prompt care.
MSSC is engaged on this issue at both the state and federal levels.
Kansas Senate bill
I provided written testimony earlier this month in support of a prior-authorization reform bill in the Kansas Senate. SB 330 would impose requirements and limitations on the use of prior authorization, including establishing time limits for responding to prior-authorization requests. It also would dictate that prior authorizations for chronic or long-term care conditions remain valid for the length of treatment and prohibit prior authorizations from being retroactively denied for a covered healthcare service.
I included in my testimony the results of a member survey that MSSC did last year. The results were clear and overwhelming:
- 93% of respondents said the prior-authorization process always or often delayed necessary care.
- 98% said the delays had a significant or somewhat negative impact on clinical outcomes.
- 90% said the number of denials increased significantly or somewhat over the past five years.
- 93% were concerned that health plans’ use of artificial intelligence will increase denial rates.
Federal legislation
MSSC members Drs. Estephan Zayat, Katie Rosell and I, along with MSSC Executive Director Phillip Brownlee, will be in Washington, D.C., later this month. We will be talking to our congressional delegation about issues impacting healthcare, including prior authorization.
MSSC endorsed the Improving Seniors’ Timely Access to Care Act (H.R. 3514 / S. 1816). The bill would streamline and modernize the prior-authorization process for Medicare Advantage plans. The bill’s chief sponsor in the Senate is Roger Marshall, R-Kan., and it has 64 co-sponsors in the Senate and 251 in the House, including all Kansas senators and representatives.
In my hospital practice, I regularly see the harm caused by Medicare Advantage’s prior-authorization processes. In addition to placing roadblocks to admitting patients, the plans frequently deny or delay post-acute care and long-term acute care. This causes patients to stay in hospitals longer than needed (taking up beds that others need) or puts them at risk when they leave, which can lead to hospital readmissions.
And now prior authorization is expanding in traditional Medicare. The Centers for Medicare and Medicaid Services rolled out this year a pilot project in six states that requires prior authorization for 17 additional services.
Slow road to relief
Though the need to reform prior authorization seems obvious to us and our patients, it is difficult to achieve. Sen. Marshall has been working on the issue for several years, and even though it has strong, bipartisan support, it has struggled to advance. Similarly, the bill in the Kansas Legislature could struggle to overcome resistance from some legislative leaders and insurance companies.
But I sense the tide may be turning, as more policymakers realize the harm that prior authorization does to patients and medical practices. Under pressure from the Trump administration, major health insurers pledged last summer to “streamline, simplify and reduce” prior authorization – though we’ll see how much really changes.
I concluded my written testimony by saying that establishing clear, enforceable time limits for insurer responses and other restrictions and protections would help ensure that patients receive medically necessary care without undue or dangerous delays. It is a message and reform that MSSC will keep pushing until physicians and patients finally get some relief.