American Hospital Association July 3, 2024

The Department of Health and Human Services’ Office of Inspector General last week announced its intent to investigate Medicare Advantage Organizations’ prior authorization denials for post-acute care after a qualifying hospital stay.

“Medicare Advantage plans must cover at least the same services as original Medicare, but Medicare Advantage Organizations (MAOs) may impose additional administrative requirements, such as requiring prior authorization before certain services can be provided,”...

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Topics: Govt Agencies, HHS, Insurance, Medicare Advantage, Post-Acute Care, Provider
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