Fierce Healthcare August 13, 2024
Prior authorization denials in Medicare Advantage (MA) jumped between 2021 and 2022, according to a new analysis from KFF.
Researchers dived into data from the Centers for Medicare & Medicaid Services and found that 46 million requests for prior auth were submitted to MA insurers in 2022, or about 1.7 requests per enrollee.
Of those requests, 3.4 million or 7.4% were denied, according to the report. By comparison, 5.8% of requests were denied in 2021, as were 5.6% in 2020 and 5.7% in 2019. Meanwhile, the number of requests per enrollee in 2022 was on par with the number submitted in 2019, the study found.
The study noted that there is notable variation between MA plans in terms of how...
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