October 22, 2025 

Dear Representatives McBath, Allen, Miller-Meeks, Ruiz, and Onder:

On behalf of the Medical Group Management Association (MGMA), I want to thank you for reintroducing the Safe Step Act (H.R. 5509), which requires employer-sponsored health plans governed by the Employee Retirement Income Security Act of 1974 (ERISA) to establish an exceptions process for any medication step therapy protocol, and for other purposes. With a membership of more than 60,000 medical practice administrators, executives, and leaders, MGMA represents more than 15,000 medical group practices ranging from small private medical practices to large national health systems, representing more than 350,000 physicians.

MGMA strongly supports this legislation and deeply appreciates your leadership in advancing reforms that improve patient care and reduce the administrative burdens associated with prior authorization in physician practices nationwide. Among the many onerous administrative processes in today’s healthcare environment, prior authorization remains one of the most burdensome for both practices and patients. Step therapy, a type of prior authorization, requires patients to try insurer-preferred treatments before accessing the therapy their clinician prescribes. These requirements often delay or disrupt necessary treatment, undermine clinical decision-making, and can result in worsened health outcomes, particularly for patients with complex or chronic conditions.

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