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Becker's Healthcare June 6, 2024
Dual-eligible special needs plan enrollees are twice as likely to have prior authorization requests denied compared to all other Medicare Advantage members, according to KFF.
According to the analysis, D-SNP carriers received nearly 670,000 prior authorization requests in 2021, which saw a 12% denial rate. The same year, all Medicare Advantage plans (which includes D-SNPs), saw a prior authorization denial rate of 6%.
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