Quote:
Originally Posted by Rainger99
Interesting study on prior authorizations.
Medicare Advantage Insurers Made Nearly 50 Million Prior Authorization Determinations in 2023 | KFF
Key points
Medicare Advantage insurers made nearly 50 million prior authorization determinations in 2023
In 2023, insurers fully or partially denied 3.2 million prior authorization requests, which is a somewhat smaller share (6.4%) of all requests than in 2022 (7.4%)
A small share of denied prior authorization requests was appealed in Medicare Advantage (11.7% in 2023)
Though a small share of prior authorization denials were appealed to Medicare Advantage insurers, most appeals (81.7%) were partially or fully overturned in 2023. That compares to less than one-third (29%) of appeals overturned in traditional Medicare in 2022. |
I fully believe fewer procedures are offered/provided to MA recipients. That would account for authorization denial numbers, patients were probably critical in the first place.