Skilled Nursing News April 28, 2022
The Department of Health and Human Services’ top watchdog arm has raised concerns over some Medicare Advantage plans that have denied certain services requested by patients, including those trying to get skilled nursing care.
MA plans issue millions of denials each year and the HHS Office of the Inspector General (OIG) found widespread and persistent problems related to inappropriate denials of services and payments to providers, a report released this week from the government agency showed.
The three most prominent service types most frequently denied were advanced imaging services (including MRIs and CT scans); post-acute care in skilled nursing facilities and inpatient rehabilitation facilities (i.e., care after hospital stays); and injections.
With enrollment in Medicare Advantage exploding across the health...
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