Becker's Healthcare August 16, 2023
Medicare Advantage may now provide health coverage to more than half of the nation’s seniors, but that is not stopping health systems from pushing back against the growing and controversial program.
Hospitals have been dropping Medicare Advantage plans over high claim or prior authorization denial rates since at least 2018, but it was an uncommon move until recently. Some systems have noted that most MA carriers have faced allegations of billing fraud from the federal government and are being probed by lawmakers over high denial rates.
Rochester, Minn.-based Mayo Clinic warned Medicare-eligible patients in Florida and Arizona in October that it does not accept most Medicare Advantage plans, and Vanderbilt University Medical Center in Nashville, Tenn., was preparing to drop...