For nearly three years, Eric Tennant endured chemotherapy infusions, rounds of radiation, biopsies, and hospitalizations that left him weak and depleted.
鈥淚t鈥檚 good to be home,鈥 he said after one hospital stay in early June, 鈥測et I鈥檓 tired and ready to get on with things.鈥
In 2023, Tennant, of Bridgeport, West Virginia, was diagnosed with cholangiocarcinoma, a rare cancer of the bile ducts that had spread throughout his body.
None of the initial treatments prescribed by his doctors had eradicated the cancer. But a glimmer of hope came in early 2025, when Tennant was recommended for histotripsy, a relatively new procedure that would use ultrasound waves to target, and potentially destroy, the largest tumor in his body 鈥 in his liver.
鈥淢y dad was a little nervous because it was something new, but it definitely gave us some hope that he would be around a little bit longer,鈥 said Tennant鈥檚 daughter, Amiya.
There was just one hitch: His insurer wouldn鈥檛 pay for it.
Tennant, 58, died of cancer on Sept. 17. His story illustrates how a bureaucratic process called prior authorization can devastate patients and their families.
It’s infeasible to count the people harmed by this , which, by delaying or denying care, helps drive health insurers鈥 profits. No government agency or private group tracks such data.
That said, 杨贵妃传媒視頻 Health News has heard from hundreds of patients in recent years who claim that they or someone in their family has been harmed by prior authorization. More than 1 in 4 physicians in December said that prior authorization had led to a serious adverse event for a patient in their care. And 8% responded that prior authorization led to a disability, birth defect, or death.
In June, the Trump administration announced a pledge, signed by dozens of private insurers, to streamline prior authorization, which often requires patients or their medical teams to ask insurers for permission before proceeding with many types of care. It remains unclear when patients can expect to see improvement.
The commitments “depend on the full cooperation of the private insurance sector鈥 and will 鈥渢ake time to achieve their full effect,鈥 said Andrew Nixon, a spokesperson for the Department of Health and Human Services. But the pledge exists, he said, 鈥渢o prevent tragic deaths like Eric鈥檚 from occurring at the hands of an inefficient system.鈥
Chris Bond, a spokesperson for AHIP, a health insurance industry trade group, said he could not speak to any specific insurer鈥檚 prior authorization policies. Broadly, though, he said prior authorization 鈥渁cts as a guardrail鈥 to make sure medicines and treatments are not used inappropriately.
At the same time, he said, insurers recognize that patients can be frustrated when their doctor-recommended care is denied. That鈥檚 why 鈥渢here is a dedicated effort across the industry to make the process more straightforward, faster, and simpler for patients and providers,鈥 Bond said.
In the meantime, the process continues to take its toll on people like Eric Tennant, whose grave diagnoses often require expensive health care services.
鈥淓ric is gone,鈥 his widow, Becky, said. 鈥淗e鈥檚 not coming back.鈥

Tennant was a safety instructor for the West Virginia Office of Miners鈥 Health Safety and Training and insured by the state鈥檚 Public Employees Insurance Agency, which contracts with UnitedHealthcare to administer benefits for state employees, their spouses, and dependents.
In February and March, UnitedHealthcare, the Public Employees Insurance Agency, and an outside reviewer issued a series of denials that concluded Eric鈥檚 benefits would not cover histotripsy, claiming the treatment was not medically necessary. Becky Tennant estimated the procedure would cost the family about $50,000 out-of-pocket.
Although the treatment wasn鈥檛 guaranteed to work, it was worth a shot, the Tennants thought, so they considered withdrawing money from their retirement savings. But then, in May, after 杨贵妃传媒視頻 Health News and NBC News posed a series of questions to UnitedHealthcare and the Public Employees Insurance Agency about Eric鈥檚 case, the agency reversed course. PEIA decided to cover his treatment.
Notably, the agency contacted 杨贵妃传媒視頻 Health News about the approval hours before it notified the Tennant family of the decision.
But the approval came too late. Eric was hospitalized in late May and prescribed medication that prevented him from undergoing histotripsy at that time. His family held out hope that his health would improve and he would qualify for the procedure that summer.
In July, they took a family vacation to Marco Island, Florida. It would be their last. Two days after they returned home, a scan revealed Eric鈥檚 cancer had continued to spread. Histotripsy was out of the question.

鈥淚鈥檓 sad for what we will miss out on,鈥 Becky said. 鈥淚鈥檓 sad at the unfairness of it.鈥
She said if Eric had been able to undergo histotripsy in February, as originally recommended by his doctor, it might have destroyed the tumor in his liver that ultimately killed him.
鈥淲e’ll never know. That鈥檚 the thing. Any lawyer for the insurance will say, 鈥榃ell, you don鈥檛 know it would have helped.鈥 No. You took that chance away from us,鈥 she said.
In October, Samantha Knapp, a spokesperson for the West Virginia Department of Administration, told 杨贵妃传媒視頻 Health News that the Public Employees Insurance Agency has not changed its policies related to prior authorization for histotripsy and continues to follow UnitedHealthcare鈥檚 guidelines.
UnitedHealthcare declined to answer questions for this article.
On Sept. 17, in a hospice bed set up in their dining room, Eric was surrounded by his family and their dogs as he died. Becky held his hand as his heart rate began to drop.
鈥淗e wasn鈥檛 afraid to die, but he didn’t want to die,鈥 she said. 鈥淎nd you could tell the last day that he was fighting it big time.鈥
At the very end, she whispered in his ear: 鈥淵ou know I love you. You have been the best husband and the best dad, and you鈥檝e always taken such good care of us,鈥 Becky recalled.
And then, she said, he gasped. His eyebrows seemed to shoot up in wonder. During his last moment alive, she said, he smiled.
鈥淭he look on his face was pure, total amazement,鈥 she said. 鈥淚 still can鈥檛 believe he鈥檚 not here.鈥

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