Becker's Healthcare January 30, 2025
Centene and CVS Health had the highest rates of prior authorization denials in 2023, according to a report from KFF.
The report, published Jan. 29, analyzed data submitted to CMS by Medicare Advantage insurers in 2023, the latest year for which data is available.
On average, MA plans denied 6.4% of prior authorization requests in 2023. MA plans requested 1.8 prior authorization determinations per beneficiary in 2023.
Individual insurers had largely similar rates of prior authorization requests and denial rates in 2023 and 2022. Centene’s rates of denials increased from 9.5% in 2022 to 13.6% in 2023, while CVS Health’s denial rates decreased...
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