CNN – A year ago, the fatal shooting of a health insurance executive on a Manhattan sidewalk unleashed many Americans’ pent-up frustration with insurers’ delays and denials of care.
UnitedHealthcare CEO Brian Thompson’s shooting shone a spotlight on the longstanding and controversial practice of prior authorization, which requires insurers to approve care in advance.
They say prior authorization is needed to help ensure that doctors provide safe, appropriate and affordable care. But providers and patients counter that such requirements are overly burdensome and slow critical testing and treatment.
Luigi Mangione, who vented his anger with the health insurance industry in diary entries before Thompson’s death, is facing charges in state and federal courts.
Mangione, who has pleaded not guilty, appeared in a Manhattan court this week as his attorneys seek to have his diary entries and other evidence tossed from his state murder case.
Thompson’s killing and the resulting public outcry led insurers and their industry associations to pledge to simplify and streamline prior authorization practices.
Top Trump administration health officials held a news conference in June to announce the voluntary multipart plan, which includes three measures set to kick in January 1.
They include reducing the number of claims that require preapproval and improving communication with patients.
However, multiple provider associations and patient advocacy groups interviewed by CNN say that little, if anything, has changed over the past year.
“From where we sit, we’ve seen no change in the burdens both providers and beneficiaries must go through to get medically necessary care,” said David Lipschutz, co-director of the Center for Medicare Advocacy.
The pledge
Navigating the prior authorization process has long been a major health care headache for Americans. It’s hard to get reliable data on delays and denials for those who have coverage through their jobs, but inappropriate denials by Medicare Advantage insurers have come under fire …
