Published 3/28/2026
On Feb. 11, the Senate Special Committee on Aging held a hearing titled “The Doctor is Out: How Washington’s Rules Drove Physicians Out of Medicine.” The hearing focused on the impact of administrative burdens such as Prior Authorization (PA) and increasing regulatory complexity relating to Medicare Advantage (MA) on provider burnout. AAOS submitted a statement for the record on two priority issues that impact the physician workforce:
The administrative burdens of prior authorization
PA requirements are put in place by MA plans to help ensure high-quality, cost-effective care while preventing unnecessary utilization. The current prior authorization system, however, imposes excessive administrative burdens on medical practices through complex requirements and electronic health record maintenance, reducing physicians’ time with patients and increasing operational costs. It also regularly delays or completely prevents patients from receiving necessary care and negatively interferes with the all-important doctor-patient relationship.
To address this issue, AAOS urges Congress to pass the Seniors’ Timely Access to Care Act (H.R. 3514), which would prioritize patient care over paperwork by modernizing and streamlining the prior authorization process in Medicare Advantage. This legislation would mandate electronic prior authorization for MA plans, standardize transactions and clinical documentation requirements, and increase transparency around MA prior authorization practices.
Inadequate Medicare reimbursement
The latest “efficiency adjustment” from the Centers for Medicare & Medicaid Services (CMS) causes further decreases in reimbursement for physician services and has wide-ranging consequences, including significant financial pressures that could limit patient access to medical care, particularly for the most vulnerable populations. This 2.5% cut in work Relative Value Units (RVUs) is built on the incorrect assumption that all non-time-based services become more efficient over time.
AAOS urges Congress to take action to delay the implementation of this “efficiency adjustment” through the Efficiency Adjustment Delay Act (H.R. 7520) and to direct CMS to study a more targeted and thoughtful approach to physician work across specialties and nationwide.