Prior Authorization Causes Significant Care Delays in Medicare Advantage, Federal Agency Report Says
A new report found that 13% of prior authorization denials in the Medicare Advantage (MA) program were for service requests that met Medicare fee-for-service coverage rules, likely delaying or preventing patient care. The report, conducted by the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG), on the impact of prior authorization within MA found that imaging services, stays in post-acute facilities, and injections were three prominent service types among the denials that met Medicare coverage rules.
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