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A major Medicare benefit just vanished

Key Medicare benefits are being stripped away, and patient care is being handed over to profit-driven corporations.

On June 25, 2025, in an unprecedented move, Dr. Mehmet Oz and Robert F. Kennedy Jr., through the Centers for Medicare & Medicaid Services (CMS), announced that Original Medicare will now require prior authorization for a list of 17 services.

This marks a major shift—and a serious rollback of a key protection retirees have relied on for decades.

What’s Changing?

Original Medicare was designed to give patients access to medically necessary care without a for-profit company standing between them and their doctor. If your doctor said you needed it, you got the care. No Prior Authorization.

Now, for the first time, CMS is launching a pilot program that uses third-party contractors to use prior authorization to review and approve services. These companies are paid based on how much money they save, which often means denying or delaying care.

What Services Are Affected?

So far, CMS has announced 3 of the 17 targeted services:

  • Knee arthroscopy for osteoarthritis
  • Electrical nerve stimulation devices
  • Skin and tissue substitutes

The remaining 14 services have not yet been disclosed.

A Move Toward Medicare Advantage Tactics

This mirrors the worst aspects of Medicare Advantage, where prior authorization is routinely used to block or delay care. One of the largest insurers, UnitedHealthcare, became infamous for their Prior Authorization strategy insiders described as:
“Deny. Delay. Defend.”

It Doesn’t Stop There

This isn’t the only rollback. The current administration also withdrew a proposal to allow Medicare to cover GLP‑1 weight-loss drugs like Ozempic, Wegovy, and Zepbound to treat obesity—a chronic condition that worsens health and drives up costs.

Covering these drugs could have improved health outcomes and reduced Medicare spending.

Why This Matters

Together, these actions represent a troubling trend:
Key Medicare benefits are being stripped away, and patient care is being handed over to profit-driven corporations.

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R Quinn
1 year ago

To characterize this as a lost major benefit is wrong both financially and for your health. No reasonable oversight is wrong. How it is administered is what matters.

mytimetotravel
1 year ago
Reply to  R Quinn

A system that pays an outfit partly or wholly based on the disapprovals it issues is clearly wrong. From the Yahoo article: “The companies that will make the prior authorization decisions will be paid a percentage of the savings that they generate for Medicare.”

R Quinn
1 year ago
Reply to  smr1082

It’s not a bad thing in concept, but a percentage of savings is not the way to go and there needs to be a fast and objective appeal.

We can’t have everything and anything we want and still complain about premiums.

Keep in mind on the healthcare care side there is the incentive to provide care.