Robert F Kennedy Jr and Dr Mehmet Oz have announced a voluntary agreement with insurance companies to reform prior authorization practices, a widely criticized system where patients must seek approval before receiving medical treatment. This practice affects the majority of Americans who are covered by private health insurance, either through employers or privatized public programs like Medicare Advantage.

Dr Oz highlighted the detrimental impact of prior authorization, citing that 85% of Americans have experienced care delays or denials due to this process. The voluntary agreement aims to standardize approval procedures, expedite decision-making, reduce the number of services requiring prior authorization, and ensure continuity of care for patients switching insurers.

This voluntary initiative, covering 275 million Americans, follows a similar pledge made by insurers in 2018 that failed to address concerns raised by doctors and hospitals. Despite the industry’s argument that prior authorization prevents unnecessary tests, critics point out its widespread use and potential harm to patients, as revealed by a survey showing adverse outcomes linked to prior authorization.

While some states, like New Jersey, have enacted legislation to improve prior authorization processes, skepticism remains about the industry’s commitment to change. Republican Congressman Dr Greg Murphy expressed doubts about insurers’ adherence to the voluntary agreement and questioned their motives behind the reform. Overall, this agreement represents a significant step towards addressing the longstanding issues associated with prior authorization practices in the US healthcare system.