Doctor Knows Best Act of 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.