Prior Authorization, Medicare Advantage
Use of Prior Authorization Up in Medicare Advantage Plans, Senate Report Finds
Medicare Advantage plans have increased their use of prior authorization and appear to be targeting certain types of care -- such as expensive post-acute hospital care -- for coverage denials, according to a report issued Thursday by the Senate Permanent Subcommittee on Investigations.
Senate report alleges MA insurers abuse prior authorization
Humana, CVS Health and UnitedHealth Group say a Senate panel is mischaracterizing spikes in prior authorization requests and denials for post-acute care.
Senate report scrutinizes Medicare Advantage prior authorization denials for post-acute care services
A report released Oct. 17 by the Senate Homeland Security Committee’s investigative subcommittee scrutinizes some of the nation's largest Medicare Advantage insurers for their use of prior authorization and high rates of denials for certain types of care.
Senate report hits top 3 Medicare Advantage insurers over ‘refusal’ of of skilled nursing, other coverage
A Senate report published Thursday blasts the nation’s three largest Medicare Advantage insurers for increasingly limiting access to post-acute care and forcing vulnerable patients into “impossible choices” to protect profits.
Medicare Advantage plans 'intentionally using prior authorization to boost profits': Senate report
The largest Medicare Advantage insurers have prioritized profits over patient care by increasing the use of prior authorization in recent years to frequently deny post-acute care services to older adults,
Medicare prior authorization affecting plastic and reconstructive surgery didn't have hoped-for effect
A new policy increased wait time for patients, but didn't speed up the move from hospital-based to outpatient-based operations.
‘Buyer beware.’ Sen. Blumenthal warns seniors about Medicare Advantage plans
Advantage plans promise to cover more services than Medicare alone, but a new report says carriers are denying patients critical rehab care. Insurers call the claims “misleading.”
Fierce Healthcare12h
UnitedHealth, CVS and Humana increasingly deploy AI and deny post-acute care claims, Senate report finds
The country’s three largest Medicare Advantage (MA) insurers obstruct seniors’ ability to receive post-acute care, a scathing ...
Skilled Nursing News7h
U.S. Senate Subcommittee Raises Alarm Over Medicare Advantage’s Denial of Post-Acute Care
Medicare Advantage’s prior authorization has resulted in higher denial rates among three of the largest health insurance ...
How UnitedHealthcare is transforming the prior authorization process for patients and providers
UnitedHealthcare is reducing prior authorization requirements with new initiatives to ease administrative tasks and other ...
TimesDaily1dOpinion
Prior authorization must be reformed
As a neurologist, I have the privilege of helping patients manage complex diseases like multiple sclerosis (MS) — a condition ...
Prior authorization delays put patients at risk: op-ed from an Alabama doctor
These delays are not just inconvenient—they are dangerous. For people with progressive diseases like MS, every missed day of ...
TMCnet1d
KLAS Reports Significant Time Saved with Surescripts Medication Prior Authorization Innovations, Leveraging Clinical Intelligence, Collaboration
The KLAS case study highlights key outcomes of a Surescripts-led collaboration with three organizations, including Cleveland Clinic, another healthcare system, and a pharmacy benefit manager. Together ...