Potter, Ujifusa Bill Aims to Reduce Prior Authorization Requirements

Legislation would free PCPs from time-consuming roadblock to patient care

 

STATE HOUSE – Rep. Brandon Potter and Sen. Linda L. Ujifusa have introduced legislation to eliminate a barrier to health care by prohibiting health insurers from requiring prior authorization for treatment and services ordered by a patient’s primary care provider.

The legislation (2025-H 5120), which was introduced in the House and the Senate this week, is meant to help patients access the care they need in a timely manner while also decreasing the administrative burden on primary care providers (PCPs) so they can focus on patient care.

“Prior authorization is a tool used by insurance corporations to block patients from getting what their doctors ordered. It’s based on the false assumption that doctors and patients ‘over-utilize’ goods and services and need to be ‘managed’ by private insurers,” said Senator Ujifusa (D-Dist. 11, Portsmouth, Bristol). “In fact, requiring PCP prior authorizations delays or prevents patients from getting tests and treatments —making diseases harder to treat or requiring trips to the emergency room. This bill allows PCPs to spend more time caring for patients, not fighting for permission from corporations who profit from limiting care.”

Freeing PCPs from the tremendous administrative burdens posed by prior authorization requirements is particularly important as Rhode Island struggles with a shortage of PCPs.

“We know all too well that Rhode Islanders are struggling to find primary care doctors, and those fortunate enough to have one are facing longer waits for appointments. The situation is only made worse when doctors have to spend their time battling insurance companies instead of treating patients. This is a step to ease that burden, expand access to basic health care, and ensure medical decisions are made by doctors based on what’s best for patients — not by insurance companies prioritizing their bottom line,” said Representative Potter (D-Dist. 16, Cranston).

The legislation would prohibit insurers from imposing prior authorization requirements for any admission, item, service, treatment, or procedure ordered by an in-network primary care provider, including general internists, family physicians, pediatricians, geriatricians, OB-GYNs, nurse practitioners, physician assistants and other health care providers who are licensed to provide, coordinate, and supervise primary care and order health care services and goods, including preventive and diagnostic services for patients.

If approved, the bill would take effect July 1, 2026.

According to the American Medical Association, which has been advocating to reduce prior authorization requirements, the average physician practice completes 45 prior authorizations per physician per week. According to the most recent AMA survey, 94% of physicians believe prior authorization delays care.

The Rhode Island Medical Society has also advocated for reductions in prior authorization requirements.

“This legislation is a step in the right direction to address the significant challenges physicians face due to prior authorization requirements. These burdens delay care, increase administrative strain, and ultimately impact patient outcomes. We appreciate the leadership of Representative Potter and Senator Ujifusa in tackling this issue and remain committed to advocating for further reforms that support timely, patient-centered care” said Rhode Island Medical Society President Dr. Kara Stavros.

President Trump is expressing condolences after recent flooding in central Texas. Trump got a close-up look at devastation in Kerrville today. During a roundtable discussion with local officials and first responders, Trump said he was there to express the anguish of the entire nation. Over 120 people are dead and many remain missing.        A farm worker is dead after an immigration raid at a Southern California cannabis farm Thursday. The United Farm Workers union announced the man's death on social media. The man's family says he fell 30 feet off a building, apparently trying to run from the ICE agents who were chasing him. The union says several other workers were critically injured during the raid in Ventura County.        President Trump is setting a 35-percent tariff on Canada. In a letter to Prime Minister Mark Carney, Trump said that starting August 1st, a 35-percent tariff on Canadian products sent into the U.S. will be imposed. Trump said it comes as part of a response to "Canada's retaliation" and ongoing trade barriers.        The deputy director of the FBI is considering stepping down. Multiple reports say Dan Bongino has told people he is thinking about resigning after clashing with U.S. Attorney General Pam Bondi over the Jeffrey Epstein files. Earlier this week, a memo stated there is no evidence that Epstein kept a so-called "client list." Bongino had been outspoken about the Epstein case in the past before he became FBI deputy director.        Pro-Palestinian activist Mahmoud Khalil is calling for accountability after filing a claim against the Trump administration. Khalil's 20-million-dollar claim alleges false imprisonment and prosecution. The Trump administration is trying to deport Khalil after he helped organize pro-Palestinian protests at Columbia. He was arrested by ICE agents last March and held for months before being released in June.        Former presidential advisor David Gergen has passed away at age 83. The New York Times reports he died at a retirement community in Lexington, Massachusetts. Gergen began his White House career in the Nixon administration and also served under Presidents Ford, Reagan and then Bill Clinton. He also worked as a political commentator and was once the editor of U.S. News and World Report.