By Dr. Mehmet Oz – The current prior authorization process creates unnecessary delays for patients, burdens health care providers with excessive paperwork, and erodes trust between payers and health care providers, even though all share the same goal: delivering high-quality patient care.
By Alix Goss – On June 23, 2025, HHS Secretary Robert F. Kennedy Jr. and CMS Administrator Mehmet Oz, announced a significant agreement with major payers to reduce the volume and burden of prior authorizations across commercial, Medicare Advantage, Medicaid, and Marketplace plans.
Many physicians fear the health insurance industry’s use of unregulated artificial intelligence (AI) automation and predictive technologies will increasingly override good medical judgment and systematically deny patients coverage for necessary medical care.
Continued physician frustration with excessive and disruptive prior authorization controls required by health insurers resulted in calls for legislative and injunctive action by the American Medical Association to fight retrospective denial of payment for care that has been pre-certified by an insurer.
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