RFK Jr. Shares Gut-Wrenching Story Of Patient Who Nearly Died Due To Pre-Auth

U.S. Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. and Centers for Medicare & Medicaid Services (CMS) Administrator Dr. Mehmet Oz announced today that major health insurers have pledged to overhaul the prior authorization process. Following a roundtable discussion hosted by HHS, insurers covering nearly 80% of Americans committed to six key reforms aimed at reducing bureaucratic delays, accelerating care decisions, and increasing transparency for patients and providers.

The reforms include reducing the volume of services requiring prior authorization by January 1, 2026, honoring existing authorizations during insurance transitions, and expanding real-time responses to minimize care delays. Insurers also pledged to ensure medical professionals review all clinical denials and to standardize electronic submissions using Fast Healthcare Interoperability Resources (FHIR®)-based APIs.

“Americans shouldn’t have to negotiate with their insurer to get the care they need,” said Secretary Kennedy. “We are actively working with industry to make it easier to get prior authorization for common services like diagnostic imaging and physical therapy.” Dr. Oz added, “These commitments represent a step toward restoring trust and helping patients receive timely, evidence-based care.”

The pledge, supported by companies like Aetna, Humana, and UnitedHealthcare, complements CMS’s ongoing efforts to improve prior authorization interoperability across Medicare Advantage, Medicaid, and commercial plans. CMS will monitor progress to ensure accountability.