HHS IG flags high, uneven denials by top Medicare Advantage plans
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.