OIG Report: Medicare Advantage Organizations Denied Prior Authorization Requests For Nursing Home Care At Higher Rates, And Overturned 97% Of Denials When Appealed
OIG had in the past raised concerns that Medicare Advantage organizations’ (MAOs’) use of prior authorization can in some cases result in denials and delays in access to needed care for enrollees. MAOs that inappropriately deny care are not delivering the full value that taxpayers pay them to pr[...]