A KFF analysis released Jan. 28 found that Medicare Advantage insurers made nearly 53 million prior authorization determinations in 2024, an increase from 49.8 million in 2023. The report found that MA insurers fully or partially denied 4.1 million (7.7%) of prior authorization requests they received in 2024, and that 11.5% of all denials were appealed. Of those, the initial denial was overturned in 80.7% of cases, similar to figures from previous years. 

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The Centers for Medicare & Medicaid Services May 28 issued a final rule making changes to the Increasing Organ Transplant Access Model beginning July 1.…
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The House Education and Workforce Committee May 21 unanimously passed the Transparency in Billing Act (H.R. 8684). The bill would require off-campus hospital…
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A KFF analysis published May 19 examined early indicators of how the expiration of the enhanced premium tax credits has impacted effectuated enrollment levels…
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The Centers for Medicare & Medicaid Services May 15 released its 2027 final standards for the health insurance marketplaces, including the issuers and…
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Approximately 35 million Americans are enrolled in Medicare Advantage plans in 2026, and that number is expected to grow to about 45 million MA enrollees by…
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A blog by Noah Isserman, AHA director of health insurance and coverage policy, explains why Anthem’s nonparticipating provider policy limits patients’ …