RFK Jr. and Dr. Oz team up with health insurers to reform "prior authorization" process
Washington DC - Health Secretary Robert F. Kennedy Jr. and Centers for Medicare and Medicaid Services Director Dr. Oz are working with health insurers to make the "prior authorization" process for patients to get the care they need much easier.
When a doctor decides that a patient is in need of a specific treatment, health insurance companies typically require proof that the treatment is necessary before they will agree to pay for it.
This process, known as "prior authorization," can be painfully long, but during a press conference on Monday, RFK Jr. and Dr. Oz revealed that they are working with a coalition of private insurers in attempt to streamline it.
A recent press release from the health insurance advocacy group AHIP broke down the six key efforts of the pledge:- standardizing electronic prior authorization submissions,
- reducing the number of medical services that require prior authorization,
- ensuring continuity of care when patients change plans,
- enhancing transparency and communication about authorization decisions and appeals,
- minimizing delays with real-time responses,
- and ensuring medical review of all denied requests.
"The pledge is not a mandate. It's not a bill, a rule. This is not legislated. This is an opportunity for industry to show itself," Oz said.
"But by the fact that three-quarters of the patients in the country are already covered by participants in this pledge, it's a good start, and the response has been overwhelming.
Kennedy agreed, calling their effort "momentous" and promising it would "work to make our country healthy again."
Will RFK Jr. and Dr. Oz be able to follow through with their plan?
Kennedy and Oz's efforts are seen as welcoming changes to the health care industry, as the complicated prior authorization process has been heavily criticized over the years.
During the press conference, Oz mentioned that there is "violence in the streets over these issues," seemingly pointing at the case of Luigi Mangione, the man accused of gunning down the CEO of UnitedHealthCare back in December.
Some critics have expressed doubt that the two leaders will be able to pull off their effort, as President Donald Trump's "Big, Beautiful Bill" is expected to cause millions of Americans to lose health insurance.
Cover photo: SAUL LOEB / AFP