PORTLAND PRESS HERALD • November 20, 2025
Leah Kovitch was pulling invasive plants in the meadow near her home when a tick latched onto her leg. She didn’t notice the tiny bug until her calf muscle began to feel sore. She made an appointment with a telehealth doctor — one recommended by her health insurance plan — who prescribed a 10-day course of doxycycline to prevent Lyme disease and strongly suggested she be seen in person. Later that day, she went to a walk-in clinic near her home in Brunswick. Staffers found another tick on her during the visit and one of the ticks tested positive for Lyme. Her insurer denied coverage for the walk-in visit. She hadn’t obtained preapproval. Prior authorization rules can block coverage for even simple, medically necessary care. The Trump administration announced this summer that dozens of private health insurers agreed to make sweeping changes to the prior authorization process. But, so far, the federal government has offered few specifics about which diagnostic codes tagged to medical services for billing purposes will be exempt from prior authorization — or how private companies will be held accountable.