IBD Policy & Advocacy News
Federal and state IBD policy highlights with links to the Crohn’s & Colitis Foundation. Education only.
Under review
Federal regulation · Prior authorization
Days, not weeks: faster prior authorization decisions
The federal CMS Interoperability and Prior Authorization Final Rule (CMS-0057-F) sets maximum turnaround times for many government-backed plans (Medicare Advantage, Medicaid managed care, CHIP, and Affordable Care Act marketplace plans). Insurers must approve or deny urgent requests within 72 hours and standard requests within 7 calendar days.
This is a crucial first step toward shorter waits for IBD tests and treatments. Patient advocates are urging federal officials to fully implement and expand these protections.
CMS fact sheet · CCF prior authorization guide · Take action (CCF)
Congress · Step therapy
Safe Step Act: reforming fail-first protocols
The Safe Step Act (H.R. 2630 / S. 652) would create a clearer appeal process when insurers require patients to try and fail on preferred drugs before covering a provider-prescribed treatment. More than 40% of IBD patients report experiencing step therapy barriers.
At a recent U.S. House committee hearing, lawmakers highlighted how step therapy can leave patients behind. The Crohn’s & Colitis Foundation continues grassroots advocacy on Capitol Hill for commonsense reform.
Recently approved & in effect
- Jan. 1, 2026: Faster prior authorization decision timelines under CMS-0057-F begin for impacted federal plans
- March 31, 2026: First public prior authorization performance metrics due from impacted payers
- Jan. 1, 2027: Prior authorization and interoperability FHIR APIs required in production (next implementation milestone)
Advocacy highlights
- Capitol Hill briefing: The Crohn’s & Colitis Foundation hosted a bipartisan briefing on how additional federal IBD research investment could accelerate prevention and treatment progress
- Step therapy in Congress: Rep. Lucy McBath cited an IBD volunteer’s story at a House committee hearing, calling step therapy a sweeping mandate that too often leaves patients behind
- Prior auth pushback: After thousands of patient letters and a rally, UnitedHealthcare delayed a planned expansion of prior authorization for many endoscopy and colonoscopy procedures
Source: Crohn’s & Colitis Foundation federal and grassroots advocacy updates.
Take action
- CCF Action Center — contact lawmakers in two clicks
- Support the Safe Step Act
- Appeal letter templates for denied biologics and treatments
- Step therapy state legislation
More resources
IBDPal site updates · About MediVue · Trusted clinical sources · Find support by state