State governments are increasingly considering legislation to streamline prior authorizations processes, which Association for Clinical Oncology (ASCO) members say delay patient care, adversely affect cancer care outcomes, and divert providers from patient care. States have regulatory authority over fully insured health benefit plans (group and individual plans) and health benefit plans administered by the state itself (Medicaid and state employee benefit plans). This means that state governments can impact plan design through either legislation or regulatory action, and during the past decade, a majority of states have been working to leverage that impact to reform prior authorization.