Becker's Healthcare July 3, 2024
HHS’ Office of Inspector General will audit Medicare Advantage plans’ use of prior authorization in post-acute care settings.
In a notice issued in June, the government watchdog said it plans to audit processes for reviewing prior authorization requests in post-acute care settings, including long-term acute care hospitals, inpatient rehabilitation facilities and skilled nursing facilities.
Previous audits have found MA plans denied some requests for post-acute care, even when beneficiaries qualified for the care under Medicare coverage rules, the OIG said.
Some hospital leaders have alleged MA plans delay or deny members transfer to post-acute care...
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