Becker's Healthcare February 9, 2023
As Medicare Advantage insurance companies continue to grow in popularity, it’s important for our nation’s health policy leaders to ensure that MA enrollees have access to the same level of medically-necessary coverage as traditional Medicare. Fortunately, CMS has proposed a rule to address this problem, and public comments are due Feb. 13.
Last year, the HHS Office of Inspector General found that MA plans frequently deny requests for needed care that meet traditional Medicare coverage rules. The OIG warned that these inappropriate denials “delay or prevent patient access to needed care, cause patients to pay out of pocket for services, and create an administrative burden for patients and providers.”
To illustrate this problem, the Louisiana Hospital Association recently posted two...
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