HealthLeaders Media February 9, 2023
New analysis further supports the need for stronger policies to streamline the administrative process.
KEY TAKEAWAYS
Kaiser Family Foundation analyzed data of Medicare Advantage contracts that included the number of prior authorization determinations made during a year an whether the request was approved.
The report found that over two million of the 35 million prior authorization requests made to Medicare Advantage plans in 2021 were denied.
Only 11% of denied prior authorization requests were appealed, but when they were, 82% resulted in in the denial being either fully or partially overturned.
More than two million prior authorization requests, accounting for six percent of the 35 million total requests, were denied by Medicare Advantage (MA) plans...
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