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A new federal watchdog report dings the three largest Medicare Advantage insurers for frequent prior authorization denials for long-term care hospital and inpatient rehabilitation stays. | A new federal watchdog report dings the three largest Medicare Advantage insurers for frequent prior authorization denials for long-term care hospital and inpatient rehabilitation stays. Another found that initial denials among skilled-nursing facilities were near-unanimously overturned.
OIG: three largest MA insurers deny prior auth at 51-80% versus 41-42% average for long-term care and inpatient rehab. Appeal overturn rates up to 95% signal improper denials; governance gaps will likely drive regulatory tightening reshaping health system authorization frameworks.
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Private Medicare Denies Rehab Care at Exceedingly High Rates

Medicare Advantage plans denied prior authorization requests at unusually high rates, HHS report finds

Patients Denied Care, Then Approved Later? Federal Watchdog Raises Medicare Advantage Concerns - UnitedHe