Regulatory burden

Priority Issues

Physicians, including neurologists, face growing administrative requirements from the federal government, insurers, and their institutions. Despite the medical community constantly working towards providing more efficient, high-quality patient care, they are forced to adhere to many redundant and ineffective processes. Neurologists need relief from overwhelming regulatory requirements, so they may prioritize caring for patients with complex brain and nervous system diseases.

The AAN supports reducing physician regulatory and administrative burdens such as prior authorization, step therapy requirements, quality reporting, and other administrative tasks so that neurology providers can spend less time on administrative tasks and more time on patient care.

Additional resources

Regulatory burden in neurology progress

The AAN has been hard at work to advocate for federal reforms to prior authorization with both Congress and the administration:

  • CMS finalized two crucial rules in April 2023 and January 2024 that fundamentally reform how Medicare Advantage (MA) plans may implement utilization management policies, including prior authorization.
    • The AAN has since responded to a Request for Information regarding further reforms to prior authorization. It is committed to working with CMS to strengthen the MA program by ensuring that care is not inappropriately denied or delayed and that MA beneficiaries maintain robust access to neurological care.
  • On June 12, 2024, the Improving Seniors’ Timely Access to Care Act was introduced in both chambers of Congress.
    • This bill, which would help reduce the administrative burden faced by physicians due to prior authorization requirements in MA plans, has been a top priority of the AAN since its first introduction in 2019.
    • The AAN worked closely with bill sponsors and the Regulatory Relief Coalition to ensure the bill’s reintroduction and will continue to work to urge Congress to pass the legislation before the end of the year.

At the state level, the AAN has been actively advocating for prior authorization reform legislation.

  • The AAN continues to actively advocate for prior authorization reform across the country to reduce delays in patient care and ease administrative burdens for neurologists. In 2024, we celebrated key legislative victories in Colorado, New Jersey, Oklahoma, and Vermont, where new laws streamlined the prior authorization process and improved patient access to timely treatment. In Colorado, legislation established an exemption program to relieve qualified providers from unnecessary prior authorization requirements. In Vermont, new protections ensure that step therapy protocols cannot require patients to fail the same medication more than once and must allow exceptions in cases of adverse reactions or lack of efficacy.
  • In 2025, the AAN is actively supporting legislation in multiple states to further reform prior authorization, including bills that would prohibit the use of artificial intelligence to deny prior authorization requests. As legislative sessions move quickly, we remain committed to ensuring that neurologists and their patients are protected from unnecessary delays and administrative roadblocks.

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