Doctors' Distrust of Insurers Slows Instant Prior Authorization, CMS Chief Oz Says

Oz cites doctors' concerns about insurers misusing data as a key barrier to real-time prior authorization approvals.

Mar. 3, 2026 at 10:07pm

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CMS Administrator Mehmet Oz, MD, MBA, says doctors' distrust of insurers is a major reason why instantaneous prior authorization hasn't happened yet. Oz says insurers claim doctors won't share data in real-time because they worry the information will be used inappropriately. He also discussed the agency's efforts to crack down on healthcare fraud, including a moratorium on new durable medical equipment suppliers and changes to ownership of existing DME companies.

Why it matters

Instant prior authorization could streamline the approval process for medical services and treatments, but doctors' concerns about data privacy and misuse are holding back progress. Oz's comments highlight the tensions between providers and insurers that are impeding this technology. The CMS efforts to curb fraud also aim to protect taxpayer funds and ensure patients receive appropriate, legitimate care.

The details

Oz said insurers claim doctors won't share data in real-time for instant prior authorization because they don't trust the insurers to use the information appropriately. He also discussed CMS actions to address healthcare fraud, including a 6-month moratorium on enrolling new durable medical equipment (DME) suppliers in Medicare and a halt on DME companies undergoing ownership changes. Oz cited examples of fraud, such as an "out-of-control" system in Minnesota for validating autism treatment payments and inflated prices for skin substitute products.

  • Oz was recruited by former President Trump 10 days after the 2024 election.
  • HHS Secretary Robert F. Kennedy Jr. stayed at Oz's home in Palm Beach, Florida for 3 months during the transition period.

The players

Mehmet Oz

CMS Administrator and former TV personality Dr. Oz.

Robert F. Kennedy Jr.

HHS Secretary during the Trump administration transition period.

Patrick Morrisey

Governor of West Virginia.

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What they’re saying

“When I ask insurance companies about why they don't accelerate prior authorization and do it instantaneously, the answer they give me -- and we've done this with all the big players -- is that doctors won't share data.”

— Mehmet Oz, CMS Administrator

“Amazingly, they say that doctors will give paper responses because they don't trust the insurance companies to use the data appropriately.”

— Mehmet Oz, CMS Administrator

What’s next

CMS plans to increase the percentage of fraud cases referred by the HHS Office of Inspector General that are investigated, aiming to reach 99% of cases.

The takeaway

Distrust between doctors and insurers is a major obstacle to implementing real-time prior authorization, which could streamline healthcare services. CMS is also taking steps to crack down on widespread fraud in areas like durable medical equipment and autism treatment payments, aiming to protect taxpayer funds and ensure patients receive legitimate care.