Medicare Advantage plans may deny prior authorization and payment requests for medically necessary care that meet Medicare coverage rules, a new report reveals.
Department of Health and Human Services Office of Inspector OIG released a report that studied prior authorization denials and payment denials by Medicare Advantage Organizations MAOs, report ignores MAOS's provide access to medically necessary services.
Last month, the U.S. Department of Health and Human Services Office of Inspector (“OIG”) released a report that studied prior authorization denials and payment denials by Medicare.
Medicare Advantage Organizations sometimes delayed or denied Medicare Advantage beneficiaries' access to services, even though the prior authorization requests met Medicare coverage rules, according to a new report by the Office of the Inspector General. Examples of healthcare services involved in denials that met Medicare coverage rules included advanced imaging services such