House bill advances “gold card” model on prior authorization

Bipartisan legislation called the “GOLD CARD Act” to give physicians relief from the time-wasting burden of prior authorization has been introduced in this session of Congress.

H.R. 4968, the Getting Over Lengthy Delays in Care as Required by Doctors Act of 2023, would exempt physicians from Medicare Advantage plan prior authorization requirements so long as 90% of the physicians’ prior authorization requests were approved in the preceding 12 months. Medicare Advantage plan-issued gold cards would be applicable only to items and services—and exclude drugs—and remain in effect for at least a year. The legislation is based on a similar law enacted in Texas that took effect in 2021.

My latest for the AMA. The whole shebang.