HHS IG flags high, uneven denials by top Medicare Advantage plans
TL;DR
An HHS inspector general report finds unusually high and highly variable denial rates for rehabilitation and other long-term care services in major Medicare Advantage plans, with some plans denying requests over 70% of the time; 95% of denials are overturned on appeal, prompting CMS to collect more data and examine insurer-wide variation as regulators consider reforms to prior authorization.
Topics:nationhealth#denial-rates#health#inspector-general#medicare-advantage#prior-authorization#private-insurers
- Medicare Advantage plans denied prior authorization requests at unusually high rates, HHS report finds NBC News
- Medicare Advantage Plans Often Deny Seniors Access to Special Care, Analysis Shows The New York Times
- Private Medicare plans erect barriers to rehab care in pursuit of profit, federal investigators find statnews.com
- Investigation Reveals Medicare Advantage Insurers Systematically Deny Care to Seniors streamlinefeed.co.ke
- RELEASE: HILL AWARDS LATEST GOLDEN FLEECE TO CMS Congressman French Hill (.gov)
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