By: Dianne Marie Normand Hartley
In a Monday press conference billed as “Secretary Kennedy, Administrator Oz to Host Press Conference to Discuss Groundbreaking Health Insurance Reform,” the topic was prior authorizations.
We won’t go into the weeds—you’ve heard it all before. In 2018. In 2023. And now again in 2025.
We weren’t in the room, but I imagine insurance executives were thrilled. Something along the lines of: “Thanks for not regulating us—of course we’ll begin to monitor ourselves. They’re starting to pop us out there.”
Because when Stat News asked the final question of a press conference notably light on specifics—
“Dr. Oz, insurers made a similar pledge in 2018 that wasn't quite lived up to. What's different this time around?”—
Dr. Oz responded:
“Secretary Kennedy alluded to that. There was another effort in 2023. I think two things have changed. Uh, I mean there's violence in the streets over these issues. This is not something that is a passively accepted reality anymore. Americans are upset about it...
Secretary Kennedy made it very clear from the outset that we're going to deal with this issue one way or the other. We have legislation pending that would codify some of these changes. But I think the major factor is the industry realizes that some of the things that are pre-authorized just don't make any sense. And they now believe that because we could actually create an interoperable digital system, a connectivity with very agreed-on standards—this actually could become a real-time process, which takes a lot of money out of the system...
They estimated earlier today that it costs between $35 and $45 per documentation of pre-authorization for the doctor's office. It costs the same amount for the insurance company for every single time. And there were 3.2 million documents last year for just Medicare Advantage. So multiply the numbers and you begin to realize we're throwing money away on administrative costs. Just financially.”
That’s somewhere between $224 million and $288 million, if our math is right.
Oz went on to say:
“We're also wasting people’s time. And we have the technology today to actually address this in a meaningful fashion. But the most important reality is the administration has made it clear: we’re not going to tolerate it anymore. So either you fix it, or we’re going to fix it. And I think they wisely have decided they should fix it.”