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Deadly Denials

Deadly Denials

Designed to prevent doctors from deploying expensive, ineffectual procedures, prior authorization — sometimes called pre-authorization or pre-certification — has become a confusing maze used by health insurance companies that denies or delays care, burdens physicians with paperwork, and perpetuates racial disparities. Proposed federal rules may not be enough to solve the problems.

Featured Story

‘Not Accountable to Anyone’: As Insurers Issue Denials, Some Patients Run Out of Options

June 16, 2025

Health insurers issue millions of prior authorization denials every year, leaving many patients stuck in a convoluted appeals process, with little hope of meaningful policy change ahead. For doctors, these denials are frustrating and time-consuming. For patients, they can be devastating.

After Series of Denials, His Insurer Approved Doctor-Recommended Cancer Care. It Was Too Late.

November 21, 2025

Eric Tennant’s doctors recommended histotripsy, which would target, and potentially destroy, a cancerous tumor in his liver. But by the time his insurer approved the treatment, Tennant was no longer considered a good candidate. He died in September.

‘They Won’t Help Me’: Sickest Patients Face Insurance Denials Despite Policy Fixes

March 31, 2025

The fatal shooting of UnitedHealthcare CEO Brian Thompson prompted both grief and public outrage about the ways insurers deny treatment. Republicans and Democrats agree prior authorization needs fixing, but patients are growing impatient.

Ticked Off Over Preauthorization: Walk-In Patient Avoided Lyme Disease but Not a Surprise Bill

November 18, 2025

A Maine woman sought care at a clinic for a tick bite, then paid full price after her insurer denied coverage. Its reason? She didn't have preapproval for the walk-in visit, even though testing later detected the pathogen that causes Lyme disease.

Fighting a Health Insurance Denial? Here Are 7 Tips To Help

September 4, 2025

Many people don’t know they can fight a health insurance denial, let alone how to do it. Here are practical tips for consumers who want to appeal a prior authorization decision.

AI Will Soon Have a Say in Approving or Denying Medicare Treatments

September 25, 2025

A pilot program testing the use of artificial intelligence to expand prior authorization decisions in Medicare has providers, politicians, and researchers questioning Trump administration promises to curb an unpopular practice that has frustrated patients and their doctors.

More Stories from the Project

Montana Looks To Regulate Prior Authorization as Patients, Providers Decry Obstacles to Care

February 13, 2025

Patients and providers say health insurers’ preapproval requirements lead to delays and denials of needed medical treatments. Insurers argue that prior authorization keeps costs down.

Deny and Delay? California Seeks Penalties for Insurers That Repeatedly Get It Wrong

February 18, 2025

A state lawmaker wants health insurers to disclose denial rates and explain those denials as anger grows over rising costs and uncovered medical care. If the bill is signed into law, health experts say, it could be one of the boldest attempts in the nation to rein in denials.

5 Takeaways From Health Insurers’ New Pledge To Improve Prior Authorization

June 24, 2025

Dozens of health insurance companies pledged on Monday to improve prior authorization, a process often used to deny care. The announcement comes months after the killing of UnitedHealthcare executive Brian Thompson, whose death in December sparked widespread criticism about insurance denials.

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Credits

Reporting

Lauren Sausser
Darius Tahir
Erin McLaughlin, NBC News
Jason Kane, NBC News
Phil Galewitz
Christine Mai-Duc
Mike Dennison
Bram Sable-Smith
Sarah Jane Tribble

Photography

Brianna Soukup
Ryan M. Kelly
Christopher Smith
Logan Cyrus
Desiree Rios

Editing

Sabriya Rice
Emmarie Huetteman
Samantha Young
Matt Volz

Copy Editing

Terry Byrne
Gabe Brison-Trezise
J.J. Evans

Illustration

Oona Zenda