Prior authorization rules are stressful for Medicare Advantage customers

The plans call prior authorization a “utilization management tool” designed to keep costs down by requiring all Medicare Advantage members to request permission before they receive medical care. If a plan determines the requested care would be unnecessary or could be provided for less money elsewhere, it can—and will—deny the requests.

There has been a lot of negative media coverage from STAT and the Kaiser Family Foundation on issues with prior authorization. And damning U.S. Health and Human Services...