A recent Kaiser Family Foundation analysis found an increase in prior authorization requests from 2019 to 2022, along with a rising share of requests that were denied.
Summary
- Prior Authorization Request Increase: More than 46 million prior authorization requests were submitted to Medicare Advantage insurers on behalf of Medicare Advantage enrollees in 2022, up from 37 million in 2019.
- Increasing Denials: In 2022, insurers fully or partially denied 3.4 million (7.4 percent) prior authorization requests. The share of all prior authorization requests that were denied increased from 5.7 percent in 2019 to 7.4 percent in 2022.
- Few Denials Were Appealed: Just one in ten (9.9 percent) prior authorization requests that were denied were appealed in 2022.
- Majority of Appeals Overturned: 2 percent of denials that were appealed resulted in overturned denials.
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