Eleven major health insurance providers on Monday voluntarily pledged to cut red tape in getting patients approved for treatments at the request of Centers for Medicare and Medicaid Services Administrator Dr. Mehmet Oz.

The insurance companies promised to reform their procedures for prior authorizations, the protocol a patient’s provider requires before it will cover specific services or treatments. Prior authorizations have been a point of frustration for patients for decades. 

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Oz, during a press conference Monday afternoon, called the measure a “brave, thoughtful first step” from insurance providers. It affects nearly eight in 10 Americans with private insurance, Medicare Advantage, Medicaid Managed Care, and the Obamacare health insurance marketplace.

These commitments, which will affect 257 million Americans, are being implemented across insurers, staying consistent with state and federal regulations.

Oz said the prior authorization process “frustrates doctors” and “sometimes results in care that is significantly delayed.”

Participating health plans will work toward standardizing electronic prior authorization for using interoperability resource applications adapted to modernize data sharing capacity in the healthcare industry. 

“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,” said Oz. “So either you fix it, [or] we’re going to fix it.”

Insurers pledged to reduce the scope of claims subject to prior authorization as appropriate for the local market each plan serves. Reductions will be demonstrated by Jan. 1, 2026.

Previously, doctors spent 12 to 15 hours a week going through prior authorizations, causing treatment delays for patients, Health and Human Services Secretary Robert F. Kennedy Jr. said.

“Some nurses spend over half their time dealing with the administrative burden of this, and healthcare is often delayed for Americans,” Kennedy said. “The cost of administration is enormous to our healthcare system, and we’re able to eliminate a lot of those costs by what we’re doing today.”

Patients will also be ensured continuity of care if they choose to change insurance plans. Beginning Jan. 1, 2026, the patient’s new plan will honor existing prior authorizations as a part of a 90-day transition period.

Health plans will also provide easy-to-understand explanations of prior authorization determinations to guide patients.

“There are many situations in this country where they, without an ethical decision for one reason or another, would not have been made, and people lose their lives because of prior authorization,” Kennedy said. 

Oz cited the high rates of preauthorization and denial of care from Medicare Advantage insurers, the privatized version of Medicare for seniors over 65.

In 2023, Medicare Advantage insurers made nearly 50 million prior authorization determinations, according to the healthcare think tank KFF. That’s up from 42 million in 2022 and 37 million in 2021. 

Roughly 3.2 million prior authorization claims were denied for Medicare Advantage beneficiaries in 2023. Of the less than 12% of patients who appealed those prior authorization denials, more than 8 in 10 denials were successfully repealed, meaning the insurance provider had to pay for the care.

Other healthcare experts during the press conference cited that routine procedures, such as vaginal delivery in childbirth, need prior authorization under the current regime. They highlighted that streamlining the process to require reauthorization only for highly specialized or unorthodox care ought to be the way of the future.

Oz said the plan to reform preauthorizations is not a mandate, but voluntary participation from insurance companies has been “overwhelming, gratifyingly so.”

“It’s not a bill or rule. This is not legislated. This is an opportunity for industry to show itself. Participation is voluntary, but by the fact that three-quarters of the patients in the country are already covered by participants in this pledge,” he said.

The insurance move is another example of the Kennedy HHS encouraging private businesses to engage in reforms sought by the Trump administration’s goal to “Make America Healthy Again.”

This spring, Kennedy and other HHS agency leaders announced their plan to reduce or ban petroleum-based food dyes, which they also did not have the regulatory power to enforce. 

But since the announcement, a handful of food companies, including Kraft Heinz, have voluntarily pledged to remove chemicals deemed harmful by Kennedy and others within the MAHA movement. 

Oz did say, however, that legislative or regulatory means are available to HHS.

“They might not be as nimble, but they will be used if we’re forced to use them,” said Oz.

Not all health insurance companies were involved in the meeting with the administration, but Oz said that “until they’re all there, we’re going to keep pushing and shoving.”

Two physicians in Congress — Sen. Rodger Marshall (R-KS) and Rep. Greg Murphy (R-NC) — are sponsoring legislation to codify the rules. Both hold key positions on health committees in their respective chambers.

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Marshall told the Washington Examiner they’re “very close” to getting legislation down the pike.

“I do think that we owe it to our patients to go ahead and codify something,” Marshall said.