The Office of Inspector General within Health and Human Services (HHS) recently released a report outlining an audit of service denials from Medicare Advantage Organizations. The full report can be found using this link.
Some of the key highlights from the report can be found below (and summarized in the video above).
The Top 3 impacted areas for these denials were:
There were three recommendations that the Inspector General is requesting of CMS (Center for Medicare and Medicaid Services).
CMS has acknowledged and agreed to implement these recommendations.
Hopefully, this improves the overall experience for Medicare Advantage Plans going forward.
See bio here