Doctor Knows Best Act of 2025
Official title: To prohibit group health plans, health insurance issuers, and Federal health care programs from applying prior authorization requirements, utilization manageme… Show full official titleShow less
Official title: To prohibit group health plans, health insurance issuers, and Federal health care programs from applying prior authorization requirements, utilization management techniques, and medical necessity reviews.
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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.
Doctor Knows Best Act of 2025
This bill prohibits health insurance plans (including federal health care programs) from imposing a prior authorization requirement, utilization management technique (e.g., step therapy or fail-first protocol), or medical necessity review for any item or service for which benefits are available under the plan.
The prohibition is effective for plan years beginning on or after January 1, 2026.
- Introduced in House Formatted Text PDF Formatted XML
- AMERICA'S HEALTH INSURANCE PLANS, INC. (AHIP)
- FORBES-TATE
- FORBES-TATE
- AMERICA'S HEALTH INSURANCE PLANS, INC. (AHIP)
- AMERICA'S HEALTH INSURANCE PLANS, INC. (AHIP)
- FORBES-TATE
Bodies those filers lobbied
- HOUSE OF REPRESENTATIVES
- SENATE
- Centers For Medicare and Medicaid Services (CMS)
- Health & Human Services, Dept of (HHS)
- Labor, Dept of (DOL)
- White House Office
- Congressional Budget Office (CBO)
- Executive Office of the President (EOP)
Cite this page
U.S. Congress. (2026). H.R. 639: Doctor Knows Best Act of 2025. 119th Congress. Open America. https://openamerica.io/bill/119-HR-639/
"H.R. 639: Doctor Knows Best Act of 2025." 119th Congress, 2026, Open America, https://openamerica.io/bill/119-HR-639/.
H.R. 639, 119th Cong. (2026), https://openamerica.io/bill/119-HR-639/.
[H.R. 639: Doctor Knows Best Act of 2025](https://openamerica.io/bill/119-HR-639/)