Hi all! As usual, they’ve been firing healthcare news at us with a t-shirt cannon, so here are a few essentials:
The good: thanks to an executive order from the governor, New Yorkers can now obtain COVID-19 vaccines from pharmacies without a Rx. Ditto for California, Washington, Oregon, Hawaii, and now Minnesota. May more follow.
The bad: given the impending removal of statewide vaccine mandates, “Florida is about to have a lot more sick kids” — who, in a just world, would only learn about mumps or rubella from Dear America books.
Deeply cursed sentence of the week: Dr. Oz is launching a federal pilot program that lets AI evaluate prior authorizations for Medicare users.
The program is set to start in January 2026 in New Jersey, Ohio, Oklahoma, Texas, Arizona, and Washington.
Let’s unpack what this means.
somehow, a less worrisome pilot program
Prior authorizations are one of the primary tools that private insurance companies use to deny or delay care. The idea of these barriers expanding into Medicare is alarming. Especially when we consider how AI tech companies have financial incentives to deny claims — leading some lawmakers to dub the pilot program “the AI Death Panel.”
In today’s subscriber episode, I put prior authorization delays into context by showing how long these processes still take when everything goes right. (Also known as: how I spent my summer vacation.)
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