Medicare Advantage plans’ excessive denials, restrictive provider networks, and contentious contract negotiations continue to increase the number of health systems dropping MA plans. This new reality leaves patients frustrated and creates significant challenges for providers searching for a sustainable solution to provide care for MA enrollees – who are projected to make up 60 percent
Medicare Advantage plans denied 7.4 percent of medical professionals’ prior authorization requests, or about 3.4 million requests, according to a recent KFF analysis of 2022 data. With just 1 in 10 patients appealing these denials, prior authorization denial often means care is foregone. For Kendra Sollars and her family, a Medicare Advantage plan’s prior authorization
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