{
Optum Home & Community Care

Companies

}

senate report reveals major insurers deny post-acute care claims using technology

A Senate report reveals that major Medicare Advantage insurers, including Humana, UnitedHealthcare, and CVS, are increasingly using technology to deny prior authorization claims for post-acute care, with Humana's denial rates soaring 16 times higher than its overall rates in 2022. The report criticizes these practices as profit-driven, urging the Centers for Medicare & Medicaid Services to enhance oversight and regulation of prior authorization processes. Insurers defend their actions, claiming compliance with CMS standards, while industry leaders call for accountability to protect patient care.
Fierce Healthcare
United States Dollar Humana Inc. naviHealth CVS Health Corporation UnitedHealthCare of Alabama Inc. Optum Home & Community Care USA Richard Blumenthal Harrison Frist Show more
Regulatory & Legal, News Article
20:00 17.10.2024
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