Skilled Nursing News October 17, 2024
Medicare Advantage’s prior authorization process has resulted in higher denial rates among three of the largest health insurance providers, whose use of predictive AI tools raises serious concerns about patient care, according to a new report issued by a Senate subcommittee on Thursday.
“[F]or beneficiaries of Medicare Advantage [prior authorization] has become not just a bureaucratic maze, but a potential threat to their health,” the report concludes.
Launched by the Permanent Subcommittee on Investigations (PSI) in spring, the report, “Refusal of Recovery: How Medicare Advantage Insurers Have Denied Patients Access to Post-Acute Care,” aimed to examine barriers in accessing necessary health care, particularly after falls, strokes, and other health issues.
“The magnitude and scope of prior authorization requests and denials...
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