RFK Jr. shared a tragic story that exposes how prior authorization delays can jeopardize lives—even when a patient is moments away from life-saving surgery. “A patient from New Jersey suffering from severe heart failure was transferred to New York Presbyterian Hospital for a lifesaving transplant.” “The patient urgently needed... a mechanical heart pump, a device essential to sustain their life during the wait.” “The insurance company had approved the heart transplant but then denied authorization for the mechanical heart pump, deeming it unnecessary.” “The decision created a perplexing contradiction. The patient was cleared for a transplant and not for the critical device needed to keep him alive.” “With the patient in the Operating Room and his life at stake, the medical team was faced with a profound ethical challenge.” “Should they adhere to the insurance company's denial, which would likely lead to the patient's death, or take action to save the patient's life knowing it could result in legal or professional consequences.” “The medical team chose to prioritize the patient’s survival in planting the mechanical heart pump.” “This decision allowed the patient to live long enough to receive a successful heart transplant.” “My friend, the doctor, was then sued by the insurance company… That lawsuit was dropped.” “There are many situations in this country where that ethical decision for one reason or another would not have been made, and people lose their lives because of prior authorization.”show more

RFK Jr. just cut healthcare costs with the stroke of a pen. Doctors were spending “12-15 hours a week filling out forms.” Nurses spent “half their time” on this. This is “one of the most important changes” MAHA has made—and it’ll save countless American lives. Thread🧵

First, bookmark this thread—This is one of MAHA’s most revolutionary moves yet. You’re about to find out why:🧵

Today, HHS Secretary Robert F. Kennedy Jr. and CMS Administrator Dr. Mehmet Oz announced a new pledge from top health insurers to fix the broken prior authorization system. UnitedHealthcare, Aetna, Cigna, Humana, Kaiser Permanente, Blue Cross Blue Shield, and others signed on. Together, they cover over 80% of U.S. patients. Insurers committed to six major changes: 1. Use standardized electronic prior authorization tools (FHIR-based APIs). 2. Cut the number of services requiring prior auth by January 1, 2026. 3. Guarantee 90-day continuity when patients switch insurers. 4. Improve transparency around decisions and appeals. 5. Provide real-time responses for most requests by 2027. 6. Require clinical review for all denials. The pledge is voluntary, but CMS says regulation will follow if insurers don’t deliver.

Dr. Oz laid out just how broken prior authorization is—and how many lives it touches. “Insurance Companies partially or fully denied 3.2 million claims… Those are individuals who, often in the most vulnerable time in their lives, needed something done, and it was denied.” “Each week, on average, a physician handles about 40 of these pre authorization issues and requests and spends about 12 hours a week on paperwork in general, often aimed at addressing the prior authorization issue.” “It frustrates doctors, it sometimes results in care that is significantly delayed and it erodes public trust in the health care system.” “It’s something that we can no longer tolerate.”

RFK Jr. says the prior authorization crisis isn’t just policy failure—it’s harming nearly every American and wasting billions in care. “85% of Americans say that they have had delays in health care because of prior authorization.” “Doctors report that it cost them 12-15 hours a week filling out forms.” “Some nurses are spending over half their time dealing with the administrative burden of this.” “The cost of administration is enormous to our healthcare system and we’re going to be able to eliminate a lot of those costs by what we're doing today.” “During the transition last January, one of the people I was bringing on as a special government advisor was a long term friend of mine called Jake Levine, and I asked Jake, can you give me the most important things that we can do very quickly as soon as we get in there?” “Jake called a professor at Harvard named David Cutler, a famous economist who spent an entire career studying the healthcare system and reforms.” “Dr. Cutler immediately said to him, you can convene the insurance companies and get them to voluntarily agree to end the scourge of pre-authorization.” “Very early on in the Administration, we brought in Chris Clump … he had met virtually all of the big insurance CEOs and hospital CEOs in this country and he spent the last several months calling them each up one by one and getting them to agree to this program.”

Dr. Oz ended the event with a clear message: this pledge is just the beginning, and if insurers don’t deliver, HHS will step in. “If the insurance industry cannot address the needs of preauthorization by themselves, there are government opportunities to get involved.” “They might not be as nimble, but they will be used if we’re forced to use them.”

Not all stories have this happy ending. The CEOs and other decision makers have caused the loss of millions of lives! I believe when they stand before God they will be held accountable for these murders. They took the patients' money then they let those patients die.

Or how about a prior authorization fiasco that caused me to be without any of my pain meds for OVER 2 weeks!! Dr Oz, you need to address the opioid issue! People are SUFFERING because of corrupted science and YOU are letting it continue!!

The doctors adhered to their oath of "First, do no harm." The insurance companies need the same frame of mind.