News Briefs: Senate Report Slams Medicare Advantage Insurers’ Post-Acute Care Denials
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Oct 18, 2024
The Senate Homeland Security Permanent Subcommittee on Investigations on Oct. 17 released a report claiming UnitedHealthcare, Humana Inc. and CVS Health Corp.-owned Aetna have increased their coverage denials of post-acute care for seniors in recent years. The report alleged that UnitedHealthcare and Aetna denied prior authorization requests for post-acute care at rates approximately three times higher than their overall denial requests, while Humana’s PA denial rate for post-acute care was 16 times higher than its overall denial rate. The report’s authors wrote the results indicate “how Medicare Advantage insurers are intentionally using prior authorization to boost profits by targeting costly yet critical stays in post-acute care facilities.” They noted UnitedHealth’s prior authorization denial rate for post-acute care increased from 10.9% in 2020 to 22.7% in 2022. During that time, the number of post-acute care service requests subjected to prior authorization increased by 57.5%, while Humana’s denial rate for long-term care acute hospitals increased by 54%. Read more
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