• Murder suspect Luigi Mangione yelled, "It's completely out of touch and is an insult to the American people and their lived experience!" as he entered a Pennsylvania courthouse.
• Mangione refused to waive extradition to New York to face charges in the killing of UnitedHealthcare CEO Brian Thompson.
• The University of Pennsylvania graduate is accused of shooting Thompson outside a Manhattan hotel as the health insurer CEO headed to a UnitedHealth Group investor meeting.

An agitated Luigi Mangione yelled at reporters outside a Pennsylvania courthouse before refusing to willingly be sent to New York to face a murder charge there in the killing of UnitedHealthcare CEO Brian Thompson.

"It's completely out of touch and is an insult to the intelligence of the American people and their lived experience!" Mangione shouted as he was led in shackles from a police car into Blair County Courthouse in Hollidaysburg.

The 26-year-old was forced into the building by two officers as he struggled against their hold on him while yelling at cameras. Before he was hustled inside, his chest bounced off the wall of the building.

It was not clear what Mangione was referring to in his rant.

At the hearing, Mangione said he would challenge extradition to New York.

The University of Pennsylvania graduate is accused by the Manhattan District Attorney's Office of fatally shooting Thompson with a pistol on Wednesday morning outside the Hilton hotel in midtown Manhattan.

The CEO was headed to an investor meeting for his parent company UnitedHealth Group.

A judge gave prosecutors 30 days to obtain documents needed for Mangione's extradition. The judge denied bail for Mangione, who will be sent back to a Pennsylvania prison pending the outcome of the extradition process.

At one point during the hearing, Mangione's defense lawyer Thomas Dickey told him to keep quiet when he began speaking as Dickey addressed the judge.

After the hearing, Blair County District Attorney Peter Weeks told reporters that his office had "already indicated" to prosecutors in New York "that we believe their charges take precedent."

"That doesn't mean we're getting rid of our charges," Weeks said, referring to the criminal charges lodged against Mangione on Monday by his office after the suspect was confronted by police in Altoona who recognized him as being wanted for questioning in New York.

A spokesperson for Manhattan District Attorney Alvin Bragg said in a statement that Bragg "will seek a Governor's warrant to secure extradition to Manhattan."

New York Gov. Kathy Hochul, in a statement, said, "I'm deeply grateful to the men and women of law enforcement whose efforts to solve the horrific murder of Brian Thompson led to the arrest of a suspect in Pennsylvania."

"I am coordinating with the District Attorney's Office and will sign a request for a governor's warrant to ensure this individual is tried and held accountable," Hochul said.

Mangione was arrested Monday morning at a McDonald's in Altoona after someone spotted him and reported him to police as suspicious.

He is being held in Pennsylvania on charges related to his possession of a 3D-printed handgun and silencer that Altoona officers found in his backpack, as well as fake identification documents.

New York police have said the gun is consistent with the weapon used to kill Thompson.

"I haven't seen any evidence that he's the shooter," Dickey told reporters after the hearing.

This is a developing story. Please refresh for updates.