OIG report reignites lawmakers’ push for action on Medicare Advantage prior authorization

The Department of Health and Human Services’ Office of Inspector General (OIG) issued a report late last week that showed MA plans at times delayed or denied beneficiary access to services that meet Medicare’s coverage requirements. While the report drew a scathing rebuke from the insurance industry, several lawmakers pressed for mandated electronic prior authorization.

“Seniors should not be denied care for routine treatments and procedures that would otherwise be covered,” according to a statement from Reps. Suzan DelBene, D-Washington; Mike Kelly, R-Pennsylvania; and Ami Bera, D-California. “This complicates...