Can RFK Jr. Break the Prior Authorization Bottleneck?

Prior authorization (PA) is a process where insurance companies must approve before paying for medications, procedures, surgeries, or other medical services.

This process started in the 1960s as part of Medicare and Medicaid ’s “utilization review” to reduce unnecessary hospital stays and manage costs.

For medications, PA approval is required for many FDA -approved (though expensive) drugs.

Health and Human Services Secretary Robert F. Kennedy Jr. announced last week that several large insurance companies, “pledged to make the changes, which will be implemented across private insurance, Medicare Advantage and Medicaid .

Delayed care risks patient harm and paradoxically increases costs for insurance companies.

RFKâ. Jr.’s voluntary approach tackles many digitization issues, like fewer approvals.