The Medical Group Management Association (MGMA) has taken a significant step in addressing one of the most pressing administrative challenges facing physicians today. In January 2026, MGMA sent a detailed letter to Congress urging lawmakers to enact prior authorization reform aimed at streamlining the approval process for medical services. The initiative highlights the growing administrative burden placed on physicians and medical staff, which detracts from patient care and contributes to burnout.
Why Prior Authorization Reform Matters
Prior authorization is a process used by health insurers to approve certain medical procedures, medications, or tests before they are provided. While designed to control costs and ensure appropriate use, the system has long been criticized for creating unnecessary administrative work, delays in patient care, and frustration among both providers and patients. According to MGMA, physicians spend countless hours managing authorizations, often at the expense of direct patient care. The 2026 letter emphasizes that streamlining this process is essential for maintaining clinical efficiency, reducing practice overhead, and allowing physicians to focus on high-quality patient care. MGMA calls for policies that standardize requirements across payers, automate requests where possible, and ensure timely responses from insurers.
MGMA’s recommendations focus on practical, actionable reforms. Reducing unnecessary documentation and redundant approvals for routine procedures, implementing consistent electronic prior authorization systems to minimize administrative delays, establishing clear timelines for insurer responses to avoid treatment delays, and encouraging transparency and accountability in denial rates and appeals are all part of the advocacy effort. The organization underscores that such reforms not only benefit physicians but also improve patient outcomes by reducing delays in accessing necessary care. MGMA’s approach balances administrative efficiency with patient safety, aiming to preserve the integrity of clinical decision-making.
Impact on Physicians and Patients
Physicians nationwide face increasing pressure from administrative tasks, which have been shown to contribute significantly to burnout. Prior authorization requirements are among the top drivers of stress in medical practice, according to recent surveys. By advocating for reform, MGMA aims to alleviate these pressures, allowing physicians to dedicate more time to patient interaction, diagnosis, and treatment planning. Patients, too, stand to benefit. Streamlined authorization processes can reduce wait times for procedures and medications, ensuring timely access to care. Improved workflow efficiency may also lead to lower healthcare costs and fewer errors caused by mismanaged approvals.
Beyond immediate time savings, prior authorization reform can improve the overall patient experience. When physicians are less bogged down by administrative burdens, they can spend more quality time educating patients about their conditions and treatment options. This enhanced communication strengthens trust, encourages adherence to treatment plans, and allows for earlier detection of potential complications. For practices, reducing delays also means better scheduling, fewer canceled appointments, and improved continuity of care, which collectively supports healthier outcomes and greater patient satisfaction.
Next Steps for Legislative Action
MGMA urges Congress to consider its recommendations before upcoming affordability hearings in 2026. Collaboration between lawmakers, medical organizations, and insurers is essential to achieve meaningful reform. By prioritizing prior authorization reform, stakeholders can foster a healthcare system that values efficiency, physician well-being, and patient-centered care.
Physicians and healthcare leaders can support MGMA’s advocacy by staying informed and participating in ongoing legislative discussions.
To read the full MGMA letter and learn how you can engage in advocacy efforts, visit the official MGMA page: MGMA Advocacy Letter on Prior Authorization Reform.
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