More than 46 million prior authorization requests were submitted to Medicare Advantage insurers in 2022, according to KFF analysis released Aug. 6 examining data submitted by MA insurers to the Centers for Medicare & Medicaid Services on prior authorization requests, denials and appeals from 2019 through 2022. The 46 million requests in 2022 increased from 37 million in 2019. MA insurers fully or partially denied 3.4 million (7.4%) prior authorization requests in 2022, which is a larger share of denied prior authorization requests by MA plans compared to previous years. Only one in 10 (9.9%) denials from that year were appealed, however, a majority of those appeals (83.2%) resulted in overturned denials.

Related News Articles

Headline
UnitedHealth Group Aug. 1 announced the creation of a gold card program for qualified practices. Under the program, the practices that earn gold card status…
Headline
The AHA July 11 released its quarterly Health Care Plan Accountability Update, a roundup of news, letters, statements and other resources covering private…
Headline
The AHA submitted a statement July 11 for a Senate Special Committee on Aging hearing on health care transparency and lowering health care costs. The AHA…
Headline
The Department of Health and Human Services July 10 released a proposed rule designed to improve health information sharing and interoperability. The Health…
Headline
The Healthcare Equality Network July 3 sent a letter to the Centers for Medicare & Medicaid Services, expressing concerns about claims denials by…
Headline
The Department of Health and Human Services’ Office of Inspector General last week announced its intent to investigate Medicare Advantage Organizations’ prior…