Skilled Nursing News May 19, 2023
As a Senate subcommittee continues to seek additional information on Medicare Advantage care denials through May, nursing home advocacy groups have issued detailed recommendations that underline lack of transparency, administrative burdens and low reimbursements associated with MA plans.
The Senate Homeland Security & Government Affairs Permanent Subcommittee on Investigations held a hearing on Wednesday that raised alarms on MA plans’ frequent denial of care of medically necessary procedures and services. The subcommittee also stressed the over reliance on Artificial Intelligence (AI) tools in place of more personalized, physician-based means of determining coverage.
Led by senators Richard Blumenthal (D-Conn.) and Ron Johnson (R-Wis.), the subcommittee intends to get a close up look at the MA plans’ denial process for corrective measures.
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