By Sean Orr, M.D. | April 13, 2026 | Florida Doctor Magazine
Forty percent of physician practices now employ multiple full-time administrative staff per doctor. Not to see patients. Not to improve care. To fight insurance companies over paperwork. That number comes from the MGMA’s 2026 Regulatory Burden Report, released April 9, and it should alarm every physician practicing in Florida.
The Medical Group Management Association surveyed leaders from more than 230 medical group practices nationwide. The findings paint a picture that will surprise no one who has tried to get a prior authorization approved on a Friday afternoon, but the scale of the problem has gotten worse. Nearly 95% of respondents reported that regulatory burden increased over the past three years. Not “stayed the same.” Not “fluctuated.” Increased. And many described the current pace as unsustainable.
The Medicare Advantage Problem
Three of the top five administrative challenges identified in the report are tied directly to Medicare Advantage: prior authorization, claim denials, and automatic downcoding. Seventy-nine percent of practices that experienced a shift toward MA reported a negative operational impact.
This matters more in Florida than almost anywhere else. More than 60% of Florida’s Medicare beneficiaries are enrolled in Medicare Advantage plans, one of the highest penetration rates in the country. With over five million Medicare beneficiaries statewide (second only to California), that means the administrative dysfunction baked into MA is hitting Florida practices harder and more often than practices in most other states.
When 90% of practices nationally say prior authorization requirements increased in the past year, and your state has one of the densest MA populations in the country, the math is simple: Florida physicians are spending more uncompensated hours fighting for routine, evidence-based care than nearly anyone else.
Burnout Is Not a Buzzword. It Is a Staffing Crisis.
The MGMA report found that 77% of respondents identified regulatory burden as a major contributor to physician burnout. That number deserves to sit for a moment. More than three-quarters of practice leaders are watching their physicians burn out, not because of the clinical work (most of us got into medicine for that part) but because of the paperwork surrounding it.
The downstream effects are already visible. Physicians are reducing hours, leaving practice, or retiring early. For patients, this translates directly into longer wait times, fewer available providers, and reduced access to care. In a state with Florida’s aging population, where physician demand already outpaces supply in many specialties and many counties, losing doctors to administrative exhaustion is a problem we cannot afford.
And then there is MIPS. Eighty-six percent of respondents said quality reporting programs increased their administrative burden. Practices reported that the Merit-Based Incentive Payment System emphasizes reporting compliance over actual quality improvement, and holds physicians accountable for costs they do not control. We are being asked to spend more time proving we deliver good care and less time actually delivering it.
What Florida Physicians Should Do Now
- Know the numbers and share them. The MGMA 2026 Burden Report is freely available and it is the strongest quantitative case in years for regulatory reform. Send it to your practice manager, your hospital CMO, and your state legislators. Data moves policy.
- Track your own prior authorization burden. If your practice is not already logging denial rates, turnaround times, and staff hours spent on prior auth, start now. The new CMS Interoperability and Prior Authorization rule requires MA plans to respond within 72 hours for urgent requests and seven calendar days for standard requests starting in 2026. You need your own data to know whether your payers are complying.
- Watch HB 693 in Tallahassee. The 2026 Florida legislative session includes House Bill 693, which contains provisions waiving prior authorization requirements for certain physician services, hospital care, and home health. Whether this bill survives committee will depend in part on whether physicians show up to testify or sit it out.
- Engage the Florida Medical Association. The FMA represents more than 22,000 physicians across the state and is actively working legislative and regulatory channels on prior auth reform and Medicare Advantage oversight. If you are not a member, this is the year to join. If you are, ask what the FMA needs from you specifically. Not in the abstract, but for the bills moving through session right now.
The Profession That Lets Itself Be Buried in Paper
The MGMA data tells us what we already feel in our clinics every day. But feelings do not change policy; organized, data-backed physician advocacy does. The 95% number is not just a statistic. It is a mandate. Nearly every practice in the country is telling us the system is broken, and Florida, with its outsized Medicare Advantage exposure and its growing, aging patient population, stands to lose the most if nothing changes.
We did not go to medical school to hire billing staff. We went to take care of patients. It is time to act like it.
Frequently Asked Questions
How does the MGMA 2026 Burden Report affect Florida physician practices?
Florida practices are disproportionately affected because the state has one of the highest Medicare Advantage penetration rates in the country, with over 60% of Medicare beneficiaries enrolled in MA plans. Three of the top five administrative burdens identified in the report (prior authorization, claim denials, and automatic downcoding) are tied to Medicare Advantage, meaning Florida physicians face these challenges more frequently than practices in lower-penetration states.
What is HB 693 and how could it help Florida doctors with prior authorization?
House Bill 693, filed in the 2026 Florida legislative session, includes provisions that would waive prior authorization requirements for certain physician services, hospital care, advanced practice nursing, physician assistant services, and home health. If passed, it could reduce the administrative time Florida practices spend fighting for approval of routine care.
What are the new CMS prior authorization response time requirements for 2026?
Under the CMS Interoperability and Prior Authorization Final Rule, Medicare Advantage plans must now respond to prior authorization requests within 72 hours for urgent cases and seven calendar days for standard requests. Practices should track whether their payers are meeting these deadlines and report violations to CMS.
How much administrative staff are practices hiring to manage regulatory requirements?
According to the MGMA 2026 report, 40% of practices have hired multiple full-time administrative employees per physician specifically to handle payer rules, audits, appeals, and reporting requirements. These are positions that do not generate revenue or improve patient care. They exist solely to navigate regulatory complexity.
What can individual Florida physicians do about rising regulatory burden?
Start by tracking prior authorization data in your own practice: denial rates, turnaround times, and staff hours spent. Share the MGMA report with colleagues and legislators. Contact the Florida Medical Association to ask how you can support specific bills during the 2026 session. Collective, organized action from physicians is the only force that has historically moved the needle on regulatory reform.
Get stories like this delivered to your inbox every two weeks — subscribe to Florida Doctor Magazine (free).