Insurance denials and prior authorization

“Stop insurers from delaying or denying medically necessary care.”

“It’s time to ban health insurance companies from denying the care your doctor says you need. And if they try to deny your claims, we’ll fine them.”

“Your care should be between you and your doctor. You work too hard and pay too much for the insurance companies to prevent you from getting the treatment your doctor prescribes.”

“Roy Cooper would lower health care costs by making sure that doctors make decisions about your health care, not insurance companies. Roy will work to reverse the Affordable Care Act tax credit expiration and cuts to Medicaid that have driven up health care costs for everyone; and put patient care first at hospitals. He’d also cap annual out-of-pocket costs for prescription drugs, and require Medicare to broaden negotiations with drug makers to make medicines more affordable.”

“Let doctors decide about health care, not insurance bureaucrats. End insurance company runarounds by allowing doctors to make coverage decisions, and reform insurance company reviews that result in denial of coverage for what a doctor says you need.”

“Roy Cooper believes that doctors should decide your health care, not insurance companies and he’d reverse the Affordable Care Act tax credit expiration and cuts to Medicaid that leave people without the coverage they need and drive up prices for everyone. He’d also require Medicare to broaden negotiations with drug makers to make prescriptions more affordable and strengthen oversight of hospital mergers that put profits over patients. He’d crack down on pharmacy benefit managers that pocket savings instead of passing them on to patients, curb surprise billing and cap annual out-of-pocket costs for prescription drugs. He’d prevent medical debt by requiring hospitals to auto-enroll patients in charity care and increase enforcement of upfront pricing to make health care costs more transparent.”

“In the Senate, I’ll fight insurance companies that send you big bills you don’t expect and deny care a doctor says you need.”

“I’m Roy Cooper, and I have a plan to stop insurance companies from ripping you off. And denying care a doctor says you need.”

“Peggy believes it’s time to ban insurance companies from using prior authorization processes for care. Too many Minnesotans have sat on the phone and begged their insurance company to cover a prescription medication, a treatment, or a surgery. A stranger behind a desk or an AI algorithm shouldn’t be able to deny you care your doctor prescribed.”

“Cut waste, fraud, and abuse in Medicare without touching anyone’s benefits. Medicare often pays about 2.5 times more for the same outpatient service in a hospital than in a doctor’s office — so paying one fair rate regardless of where care is delivered (“site-neutral”) could save more than $150 billion over a decade. Private Medicare Advantage plans, meanwhile, are projected to be overpaid by roughly $76 billion in 2026 because they document members as sicker than they really are. These are real opportunities for Republicans and Democrats to save billions in taxpayer dollars. Adam would go after both problems, and he would reform prior authorization so insurance paperwork cannot delay or deny care that doctors say patients need. This should be common ground.”

“Chris believes that quality health care should be affordable and available for every American. Granite Staters shouldn’t be forced to travel hours to see a doctor, only to leave with a bill they can’t afford. Treatment plans should be determined by your doctor, not an insurance company thousands of miles away. And no one should be forced to ration lifesaving medications to pay their bills.”

“He is running for Senate to stand up to insurance companies and their army of lawyers and lobbyists that indiscriminately deny coverage while reaping record profits. He will work to hold insurance companies and big pharmaceutical companies accountable for soaring prices and diminishing care, and he will fight to restore the ACA premium credits Republicans ended.”

“Now he’s fighting to crack down on big insurance companies and working to stop them from denying patients tests and treatments they need.”

“Reform the prior authorization system: Ensure that insurance companies do not arbitrarily deny patients the medication and treatments that their health care providers have determined necessary.”

“Secondly, I think that we can put guardrails on insurance. I mean, insurance rates are skyrocketing. I’m someone that believes that doctors should be deciding care, not insurance companies.”

“Prohibit insurance companies from denying care that is prescribed by a doctor.”

“Prohibit insurance companies from denying medically necessary care for cancer patients.”

“Let doctors decide about health care, not insurance bureaucrats. End insurance company runarounds by allowing doctors to make coverage decisions, and reform insurance company reviews that result in denial of coverage for what a doctor says you need.”

“Ban AI-based prior authorization. Automated denial systems are overriding physician judgment at scale, delaying or denying healthcare your doctor said you need. No algorithm should be able to deny care that a licensed physician has determined is necessary. Prior authorization decisions must be made by a licensed physician with full access to the patient’s record and subject to binding physician-to-physician review on appeal.”

“Cut waste, fraud, and abuse in Medicare without touching anyone’s benefits. Medicare often pays about 2.5 times more for the same outpatient service in a hospital than in a doctor’s office — so paying one fair rate regardless of where care is delivered (“site-neutral”) could save more than $150 billion over a decade. Private Medicare Advantage plans, meanwhile, are projected to be overpaid by roughly $76 billion in 2026 because they document members as sicker than they really are. These are real opportunities for Republicans and Democrats to save billions in taxpayer dollars. Adam would go after both problems, and he would reform prior authorization so insurance paperwork cannot delay or deny care that doctors say patients need. This should be common ground.”

“Reform the prior authorization system: Ensure that insurance companies do not arbitrarily deny patients the medication and treatments that their health care providers have determined necessary.”

“AI No-Gos: AI may not deny medical care, autonomously fire weapons, conduct warrantless surveillance, replace human oversight in life-or-death decisions, or make hiring or firing decisions.”

“Ban AI-based prior authorization. Automated denial systems are overriding physician judgment at scale, delaying or denying healthcare your doctor said you need. No algorithm should be able to deny care that a licensed physician has determined is necessary. Prior authorization decisions must be made by a licensed physician with full access to the patient’s record and subject to binding physician-to-physician review on appeal.”

“AI shouldn’t be able to deny you healthcare. It shouldn’t be able to deny you a job. It shouldn’t be able to fire you. It shouldn’t be able to fire a weapon. There are things that we should not be using AI to do, and we collectively have to decide that we need public oversight so that all of this technology is not being created for the interests of a few against the well-being of the many.”

“I categorically oppose the use of AI to allow health insurance of any kind to second-guess decisions made by your doctor.”

“Peggy believes it’s time to ban insurance companies from using prior authorization processes for care. Too many Minnesotans have sat on the phone and begged their insurance company to cover a prescription medication, a treatment, or a surgery. A stranger behind a desk or an AI algorithm shouldn’t be able to deny you care your doctor prescribed.”

“Until recently, supporting Medicare was an issue that we all agreed on. In the Senate, Peggy will fight back against cuts to Medicare and Donald Trump and Health and Human Services Secretary Robert F. Kennedy Jr.’s plan to use AI for prior authorization to dictate what care seniors receive, as opposed to the doctors who prescribe it.”

“Ohioans deserve a senator who will lower costs. That’s why, in the Senate, I’ll fine insurance companies for wrongly denying claims and make it illegal for drug companies to charge more in America than they do overseas for the same medicine.”

“It’s time to ban health insurance companies from denying the care your doctor says you need. And if they try to deny your claims, we’ll fine them.”

“Peggy believes it’s time to ban insurance companies from using prior authorization processes for care. Too many Minnesotans have sat on the phone and begged their insurance company to cover a prescription medication, a treatment, or a surgery. A stranger behind a desk or an AI algorithm shouldn’t be able to deny you care your doctor prescribed.”

“Ban AI-based prior authorization. Automated denial systems are overriding physician judgment at scale, delaying or denying healthcare your doctor said you need. No algorithm should be able to deny care that a licensed physician has determined is necessary. Prior authorization decisions must be made by a licensed physician with full access to the patient’s record and subject to binding physician-to-physician review on appeal.”