Health insurers have spent the past year touting how they've cut pre-treatment review claims, but new data suggests that hasn't eliminated hurdles for patients and doctors.

The big picture: By only approving some, but not all, doctor-ordered care, health plans still can force physicians to revise treatment plans, delay procedures or leave patients paying more out of pocket.

By the numbers: Big health insurers in Medicare Advantage and commercial plans as well as Medicaid denied fewer than 1% of so-called prior authorization requests, according to data from Silna, a software company that provides AI-powered support to providers.

• However, roughly 15% of all requests for physical therapy, occupational therapy and speech therapy were only partially approved, the data shows.
• While the findings represent only a small cross section of all medical services, they raise questions about whether the focus on streamlining and cutting red tape is obscuring an important piece of the patient experience.
• "If we come out and say, hey, prior authorizations are required less, and total denials are less than 1%, you'd be like, 'We solved it. That is fantastic,'" said Silna CEO Jeffrey Morelli.
• "When you talk to the average person walking down the street in New York, they'd say, 'No, this is a problem,'" he said.

Between the lines: A KFF analysis of prior authorizations in Medicare Advantage plans showed about 1 million requests for care were partially denied through prior authorization reviews in 2024, Jeannie Fuglesten Biniek, a KFF deputy program director, told Axios.

• But beyond that, there is little publicly available data breaking down which services are likeliest to be turned down or how those decisions affect patient care.
• An HHS inspector general report recently found that Medicare Advantage plans in June 2024 overturned nearly all prior authorization denials for skilled nursing or rehabilitative care when they were appealed.

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Taking GLP-1 drugs didn't materially improve diabetic patients' mental health, job or marriage prospects, a new working paper published by the National Bureau of Economic Research finds.

Why it matters: While the drugs' health benefits are well documented, there's been much less study of whether they improve other parts of people's lives.

• The non-health benefits have increasing policy significance as public and private insurers weigh the benefits of expanding access to the injectables and pills, researchers said.

Driving the news: Economists studied more than a decade's worth of data on adults with diabetes after they began taking GLP-1s, looking for changes in well-being — including symptoms of depression or distress, as well as employment and marital status.

• While initial comparisons showed GLP-1 users did better on measures like employment and marriage, those differences largely disappeared over time, suggesting improvements were more a reflection of the individuals than changes caused by the drugs.
• For people with diabetes, the value of the drugs lies mostly in managing blood sugar levels and weight loss, the University of Chicago and Georgia Southern University researchers wrote.

Between the lines: Some recent studies have suggested positive non-health outcomes for GLP-1 users, including how women fared in jobs and relationships.

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A federal appeals court yesterday revived hundreds of lawsuits alleging that use of Tylenol or acetaminophen during pregnancy can cause autism or attention deficit hyperactivity ‌disorder in kids.

Why it matters: President Trump and his top health officials suggested such a link last year, despite medical findings that there's no clear evidence of a relationship.

Driving the news: The 2nd U.S. Circuit Court of Appeals ruled that a lower court excluded expert witness testimony on behalf of plaintiffs pressing claims against Tylenol's manufacturer.

• The decision sends the cases back to U.S. District Judge Denise Cote, who had dismissed the lawsuits in 2024 and criticized the expert witnesses' methodology.
• Circuit Judge Guido Calabresi, writing for the three-judge panel, said the appeals court was not deciding whether using acetaminophen causes autism or ADHD, or whether elected officials should do more ⁠to protect public health, per CNBC.

Tylenol maker Kenvue said in a statement that the ruling doesn't change the fact that there's no proven link, adding it provides another opportunity to show that the opinions of plaintiffs' experts are unreliable and should not be allowed.

🥼 HHS won't finalize a proposal that would have blocked Medicaid and Medicare funding for hospitals that provide pediatric gender-affirming care. (NPR)

👨🏼‍⚕️ The FDA completed clinical guidance for developers of psychedelic drugs and scheduled a hearing on future therapeutic use. (Endpoints)

🧠 The agency also approved a starter dose of the Alzheimer's treatment Leqembi that can be administered by injection at home. (Drug Topics)

🏥 Regulators delayed a major overhaul of the HIPAA security rule, pushing back final action by a year. (Fierce Healthcare)