MedPAC Focus Groups Find Doctors Frustrated With Medicare Advantage Prior Authorization, Patients Rely on Pharmacists for Drug Cost Help

Medicare's congressional advisory commission, MedPAC, released findings at its November 5 and 6, 2026 public meeting drawn from focus groups conducted with Medicare beneficiaries, physicians, nurse practitioners, and pharmacists. The 2026 round marked the first time the commission included pharmacists in its annual beneficiary and clinician study.

For routine care, focus-group beneficiaries reported no major access problems, with wait times ranging from a few days to about a month. Waits for specialty care were described as longer than for primary care. Nearly all clinicians across locations said they were accepting new Medicare patients.

A recurring theme from the clinician groups was frustration with prior authorization requirements applied to Medicare Advantage patients. Clinicians described obtaining plan approvals as causing delays in care and creating tension with patients, who sometimes blamed their doctors rather than the plan.

On the drug cost side, beneficiaries reported that both their clinicians and pharmacists offered ways to lower prescription costs, suggesting pharmacists are serving an active advisory role alongside prescribers. The addition of pharmacist participants is part of MedPAC's broader review of pharmacy access trends and changes to Part D following recent federal legislation. The commission plans further analysis of how pharmacy closures and network designs affect medication access for Medicare enrollees.