The suspect in the killing of UnitedHealth Group executive Brian Thompson has been transferred into the New York Police Department custody to face murder charges after he waived his right to extradition proceedings in a Pennsylvania court hearing.
Luigi Mangione, 26, appeared in an orange jail jumpsuit at the Blair County courthouse, where he consented to surrender to the New York police officers who also attended the short hearing.
He departed the courthouse in a New York police vehicle and is expected in Manhattan later.
A grand jury in New York has indicted Mr Mangione on 11 counts, including first-degree murder and murder as an act of terrorism.
Mr Mangione has been in jail since his arrest. His New York defence lawyer Karen Friedman Agnifilo has declined to comment on the charges against Mangione.
He was arrested in Altoona, Pennsylvania on 9 December, five days after Mr Thompson was fatally shot outside a Manhattan hotel before a company conference in what law-enforcement officials have called a premeditated assassination.
While the killing of Mr Thompson has been broadly condemned, Mr Mangione has been feted as a folk hero by some Americans who decry the steep costs of healthcare and the power that insurance companies have to deny paying for some medical treatments.
A small crowd of supporters stood outside the courthouse, some waving signs that condemned the health insurance industry.
Last night, the New York Times reported that Mr Mangione would also face charges from federal prosecutors in Manhattan, citing unnamed people familiar with the matter.
It was not immediately clear what those charges would be.
Federal charges would potentially allow prosecutors to pursue the death penalty, which has been outlawed in New York for decades, according to the report.
A spokesperson for the US attorney’s office in Manhattan declined to comment.
In Pennsylvania, police said Mr Mangione had a self-assembled 9mm handgun in his backpack and a homemade silencer when he was arrested after being spotted at a McDonald’s restaurant.
The handgun resembled the weapon used to kill Mr Thompson, CEO of UnitedHealthcare, the largest US health insurer.
Mr Mangione, a Maryland native who had lived in Hawaii, also had multiple fake identification documents, including a fake New Jersey ID that was used to check into a Manhattan hostel days before Mr Thompson’s shooting, police said.
In Pennsylvania, Mr Mangione has been charged with forgery and illegally possessing an unlicensed gun.
At the courthouse, Mr Mangione had a preliminary hearing for the Pennsylvania charges, immediately followed by a second on New York’s extradition request.
The Pennsylvania prosecutors told the court they had agreed to pause the Pennsylvania proceedings until after the conclusion of the New York prosecution.
Mr Mangione spoke only briefly at the extradition hearing, saying he understood his rights and telling Judge David Consiglio he consented to surrender to New York police.
Manhattan District Attorney Alvin Bragg’s office is accusing Mangione of an act of terrorism under New York law because Thompson’s killing was intended to intimidate or coerce civilians or “influence the policies of a unit of government.”