RFK Jr. Announces Most Insurance Companies Will Now Give ‘Immediate Pre-Authorization’

The insurance practice gained heightened scrutiny after Luigi Mangione allegedly gunned down the CEO of UnitedHealthcare over costs.

Steven Hirsch/AP Pool
Luigi Mangione, accused of fatally shooting UnitedHealthcare CEO Brian Thompson in New York City and leading authorities on a five-day search, appears in court for a hearing February 21, 2025. Steven Hirsch/AP Pool

The Department of Health and Human Services secretary, Robert F. Kennedy Jr., has announced a “historic agreement” with insurance companies that they will now give “immediate pre-authorization” on most medical procedures prescribed by doctors.

The prior authorization system requires insurers to approve medical tests, procedures, and medications before patients can receive them — a cost-control measure that has become increasingly controversial among healthcare providers and patients.

“We have an historic agreement on pre-authorization,” Mr. Kennedy told President Trump during a two-hour Cabinet meeting in the White House. “We brought together 80 percent of the insurance industry, which has agreed to — for 80 percent of diseases and injuries — give immediate pre-authorization, so that when you go to your doctor’s office and he prescribes you a new knee or whatever it is, you will immediately know whether your insurance company is going to pay for it.”

“People have been trying to do it for decades, and we, because of your leadership, brought the insurance industry together and got them to voluntarily agree to do this,” he said.

The insurance practice gained heightened scrutiny after the December shooting death of Brian Thompson, CEO of UnitedHealth’s insurance division, at New York City. The alleged shooter, Luigi Mangione, has become somewhat of a modern-day folk hero, and the company later faced numerous allegations that it was far too stringent on granting pre-authorizations.

The issue first arose in June, when Mr. Kennedy said he was working with insurance companies on pre-authorization. On Tuesday, the secretary said most health insurers have promised to take steps to streamline the often-criticized authorization process.

When discussing the issue in June, Mr. Kennedy said he was working with seven major insurance companies, including Blue Cross Blue Shield Association, Cigna, Elevance Health, GuideWell, Humana, Kaiser Permanente, and UnitedHealthcare. The changes would apply across private insurance, Medicare Advantage, and Medicaid plans, he said.

But Mr. Kennedy in June also warned that insurance companies made similar reform pledges in 2018 and 2023 that largely went unimplemented.

He made two other healthcare announcements during the Cabinet meeting.

“We made another historic agreement with personal health records,” he said. “The 60 biggest tech companies in our country have all agreed to allow Americans, for the first time, access to their personal data — which they own — which these companies have been monetizing without permission.”

“You’re going to be able to see, by next year, all of your health records on your cell phone. It’s going to save lives. It is going to fuel an infusion of technology into that space where people can access those records. They can compare their diet to what they personally need. And we’ll have personalized medicine,” Mr. Kennedy said.

Mr. Kennedy also told Mr. Trump, “We are doing price transparency. You passed this during your first term, and then the Biden administration refused to enforce it. We’ve now brought an HHS, under your leadership and my leadership, more enforcement actions than during the entire four years of the Biden administration. So we’re going to have that kind of price transparency.”


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