Senate report accuses major Medicare Advantage insurers of profit-driven denial of post-acute care services.

A Senate report accuses major Medicare Advantage insurers, UnitedHealthcare, Humana, and CVS, of prioritizing profits by frequently denying prior authorization for post-acute care services. The denial rates for these services are significantly higher than overall rates, with some insurers denying requests up to 16 times more often. The report calls on the Centers for Medicare & Medicaid Services to collect data, conduct audits, and regulate the use of AI in decision-making to protect patient care.

October 17, 2024
12 Articles