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Doctor Knows Best Act of 2025

USA119th CongressHR-639| House 
| Updated: 1/22/2025
Jefferson Van Drew

Jefferson Van Drew

Republican Representative

New Jersey

Energy and Commerce Committee, Oversight and Government Reform Committee

  • Introduced
  • In Committee
  • On Floor
  • Passed Chamber
  • Enacted
This bill proposes a significant change to health care administration by prohibiting specific practices across various health coverage entities. It mandates that group health plans , health insurance issuers , and Federal health care programs cannot impose prior authorization requirements , utilization management techniques , or medical necessity reviews on any covered item or service. The prohibition on utilization management techniques explicitly includes practices like step therapy and fail-first protocols . For private insurers, these changes will apply to plan years beginning on or after January 1, 2026. Federal health care programs, including state-administered ones, will be subject to these restrictions starting January 1, 2026, aiming to streamline access to care by removing these administrative hurdles.
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Timeline

Bill from Previous Congress

HR 118-6230
Doctor Knows Best Act of 2023
Jan 22, 2025
Introduced in House
Jan 22, 2025
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.
  • Bill from Previous Congress

    HR 118-6230
    Doctor Knows Best Act of 2023


  • January 22, 2025
    Introduced in House


  • January 22, 2025
    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.

Health

Health care costs and insuranceHealth care coverage and access

Doctor Knows Best Act of 2025

USA119th CongressHR-639| House 
| Updated: 1/22/2025
This bill proposes a significant change to health care administration by prohibiting specific practices across various health coverage entities. It mandates that group health plans , health insurance issuers , and Federal health care programs cannot impose prior authorization requirements , utilization management techniques , or medical necessity reviews on any covered item or service. The prohibition on utilization management techniques explicitly includes practices like step therapy and fail-first protocols . For private insurers, these changes will apply to plan years beginning on or after January 1, 2026. Federal health care programs, including state-administered ones, will be subject to these restrictions starting January 1, 2026, aiming to streamline access to care by removing these administrative hurdles.
View Full Text

Suggested Questions

Get AI-generated questions to help you understand this bill better

Timeline

Bill from Previous Congress

HR 118-6230
Doctor Knows Best Act of 2023
Jan 22, 2025
Introduced in House
Jan 22, 2025
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.
  • Bill from Previous Congress

    HR 118-6230
    Doctor Knows Best Act of 2023


  • January 22, 2025
    Introduced in House


  • January 22, 2025
    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.
Jefferson Van Drew

Jefferson Van Drew

Republican Representative

New Jersey

Energy and Commerce Committee, Oversight and Government Reform Committee

Health

  • Introduced
  • In Committee
  • On Floor
  • Passed Chamber
  • Enacted
Health care costs and insuranceHealth care coverage and access