Nurses who spend hours each week chasing insurance approvals for medications, procedures, and specialist referrals may soon get federal backup. The Prior Authorization Accountability Act (H.R. 9396) cleared the House Energy & Commerce Committee on a bipartisan vote on June 25, 2026, advancing the most comprehensive federal prior authorization reform in years to the full House floor.
The bill would impose strict new timelines on health insurers processing prior authorization requests: 72 hours for standard, non-urgent decisions and 24 hours when a treating clinician certifies urgency. Under current law, no federal mandate governs commercial insurer response times, leaving nurses and patients waiting days or weeks for approvals that can delay discharge planning, medication starts, or home health referrals.
What the Bill Requires
Beyond response deadlines, H.R. 9396 targets three practices nurses identify as the most disruptive:
- Same-specialty peer-to-peer reviews. When an insurer denies a request and a clinician requests a peer-to-peer review, the insurer must provide a reviewer in the same specialty or a directly related specialty — not a generalist reviewer overriding a specialist's clinical judgment.
- Continuity of care protections. Insurers may not change or revoke a prior authorization mid-treatment when a patient is already receiving approved care, a practice that has forced nurses to restart approval cycles on active patients.
- Transparency reporting. Insurers would publish annual data on approval rates, denial rates, average response times, and appeal outcomes by clinical category — creating public accountability for bottlenecks that today go largely unreported.
Why Nurses Are Watching This Bill
Prior authorization burden consistently ranks among the top drivers of nursing and clinician burnout in workforce surveys. A 2025 American Medical Association survey found that 93% of physicians reported prior auth caused care delays, and nearly one in three reported a serious adverse event linked to a prior auth delay. Nurses — who often serve as the intermediary between insurers and the clinical team — shoulder a disproportionate share of that administrative load.
The American Nurses Association (ANA) has been a vocal advocate for prior auth reform, arguing that the current system redirects registered nurses from bedside care to phone queues and fax machines. In testimony submitted to the House subcommittee in May 2026, ANA cited studies showing direct care nurses spend an average of 4–6 hours per 12-hour shift on documentation and administrative tasks, with prior authorization follow-up cited as a leading contributor on medical-surgical and telemetry units.
Bipartisan Support — and What Comes Next
The bill passed the full committee with support from members of both parties, a notable development in a Congress where healthcare bills often stall along partisan lines. The prior auth issue has built unusual cross-aisle support: fiscal conservatives argue delayed care leads to preventable hospitalizations and higher downstream costs, while progressive members focus on patient harm and workforce equity.
The bill now heads to a full House floor vote. The Senate has a companion measure, though no Senate floor vote had been scheduled as of late July 2026. Advocates note that prior auth reform has passed the House before — the Improving Seniors' Timely Access to Care Act passed 416-12 in 2022 before stalling in the Senate — and are pushing for a conference agreement this session.
If enacted, the law would apply to commercial health plans regulated under ERISA, ACA marketplace plans, and Medicaid managed care organizations — covering the majority of insured Americans. Medicare Advantage prior auth reforms, which CMS finalized in a January 2024 rule requiring 72-hour standard and 24-hour urgent timelines for MA plans, were seen as the template H.R. 9396 follows for the broader insurance market.
The Bottom Line for Nurses
House committee passage does not guarantee enactment, and Senate timing remains uncertain. But the bipartisan momentum behind H.R. 9396 is the strongest prior auth reform has seen in years. If it clears both chambers and is signed, nurses at hospitals, clinics, and home health agencies could see measurable reductions in the administrative overhead that pulls them away from patient care — and the transparency provisions would, for the first time, create public data on exactly which insurers cause the longest delays.
ANA and state nursing associations are urging nurses to contact their senators during the August recess to push for Senate action before the fiscal year ends in September.