McKnight's October 20, 2024
John O'Connor

Skilled care operators have long been accused — often unfairly — of prioritizing profits over resident care.

But if a new Senate report is to be believed, even the greediest nursing facilities might seem saintly compared to the shenanigans coming from the nation’s largest Medicare Advantage companies.

The majority staff’s 54-page report, released last week, doesn’t mince words. Investigators specifically call out UnitedHealthcare, Humana and CVS for denying critical post-acute care services to boost their bottom lines.

The details are alarming: UnitedHealthcare’s denials of skilled nursing facility admissions skyrocketed ninefold between 2019 and 2022. The culprit? AI-powered tools designed to reject more claims. And unfortunately, other MA firms are following suit.

These same insurers proudly market themselves to the public...

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Topics: Congress / White House, Govt Agencies, Insurance, Medicare Advantage, Post-Acute Care, Provider
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