On March 27, 2025, Representatives Mark Green (R-TN), Kim Schrier (D-WA), and Greg Murphy (R-NC) re-introduced H.R. 2433, the Reducing Medically Unnecessary Delays in Care Act of 2025. This bill aims to improve the prior authorization process in the Medicare and Medicare Advantage (MA) programs by clarifying rules around “medically necessary” care. The bill would require that all prior authorization decisions be reviewed by a board-certified physician in the relevant specialty and that MA and Medicare Part D plans disclose their standards for medical necessity, which must be based upon written clinical guidelines and published on their website. The bill also would require that MA and Medicare Part D plans to disclose statistics on prior authorization denials, including the medical specialty, medication or procedure requested, and reasons for denial.

Impact on General Dentistry: This legislation could impact healthcare overall by streamlining the prior authorization process in Medicare and MA programs. The AGD supports initiatives to reduce delays in care and improve patient outcomes.