Care Denials – medicarereport.org

A trusted source for Medicare news and education from the AMAC Foundation.

Payers’ prior authorization denial rates go public: 5 notes

(By: Jakob Emerson for Becker’s Hospital Review ) For the first time, payers must publicly post data on how often

Eileen Cook March 31, 2026March 31, 2026 Care Denials, CMS, Prior Authorization

Artificial Intelligence Health Insurance Legal Actions/Court Decisions Medicare Advantage

UnitedHealth faces class action lawsuit over algorithmic care denials in Medicare Advantage plans

(By Casey Ross and Bob Herman for ST A T) A class action lawsuit was filed Tuesday against UnitedHealth Group

Eileen Cook November 15, 2023November 15, 2023 algorithm, Care Denials, Class Action Lawsuit, CMS, Medicare Advantage, Older Adults

CMS Legislative Update Medicare Advantage

Senators probing largest Medicare Advantage plans over how algorithms factor in care denials

(By Bob Herman and Casey Ross for ST A T) Senators warned the country’s largest Medicare Advantage insurers at a

Eileen Cook May 18, 2023May 18, 2023 Algorithms Factor, Care Denials, CMS, Medicare Advantage, Medicare’s Coverage rules