A new survey finds that Medicare patients covered by corporate insurance companies through Medicare Advantage (MA) are more likely than those in traditional Medicare to report delays in accessing care due to prior authorization. The findings provide the latest in a growing body of evidence showing that corporate insurance companies are delaying and denying patient care while they bank record profits.
- Fierce Healthcare reports that “22% of MA enrollees experienced delays in receiving care because of needing insurance approval for a test or procedure, versus just 13% of traditional Medicare beneficiaries.”
- POLITICO notes that “[t]he findings come as lawmakers on both sides of the aisle scrutinize care denials in Medicare Advantage and after the Biden administration issued a final rule last month reforming prior authorization, a tool critics say is used to delay or deny patient care.”
An investigation by NBC News found that corporate insurers “routinely reject claims for necessary care” for Medicare Advantage patients. The Washington Post reported recently that the prior authorization process “can be confusing and lengthy. Denials are common and appeals are often difficult to navigate. Doctors say some people end up dying while waiting for an insurer’s permission for care.”
As evidence continues to show that corporate insurers routinely delay and deny care through excessive or inappropriate prior authorization practices – including denying more than two million Medicare Advantage claims in 2021 alone – a report by the Medicare Payment Advisory Commission (MedPAC) recently uncovered that corporate insurance companies are projected to cost taxpayers $88 billion more in 2024 through the Medicare Advantage program than the government would have spent through traditional Medicare.
Yet today, these same corporate insurance companies are pushing Congress to enact harmful Medicare cuts to patient care that would jeopardize Americans’ access to 24/7 health services that only hospitals provide. Lawmakers should reject these proposed Medicare cuts that would put patients at risk.