Medicare Advantage (MA) plans received more than 2 million prior authorization requests in 2021, of which about 6% were denied. This statistic, sourced from the Kaiser Family Foundation (KFF), illustrates the challenges MA users face in receiving the necessary treatments and medications.
It is important to note that prior authorization is not only about controlling costs, but also ensuring that patients receive the treatments and medications that are most suitable for them. However, the high denial rate for prior authorization requests can add additional barriers for patients in need of medical care.
The KFF report highlights the need for MA plans to review their prior authorization requests and reduce the denial rate. Doing so would result in greater access to medically necessary treatments and medications for Medicare Advantage users.
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