Largely driven by prior authorization, MA and Part D coverage denials leave beneficiaries with only bad options: paying out-of-pocket, going without, or getting embroiled in a daunting and deeply flawed appeals process. Each path can lead to delayed care, abandoned therapies, worse health, and higher costs. Particularly egregious are improper coverage denials, which force people to make this choice unnecessarily. Changes are long overdue. Harmful denials must be curbed, and the appeals systems must be reformed to function as a safety valve—rather than as an inadequate substitute for sound plan decisions and robust federal oversight.
This report features the top helpline trends and highlights the most commonly sought helpline and Medicare Interactive answers, providing a glimpse into the various questions and needs of Medicare beneficiaries, caregivers, and the professionals assisting them in the community in 2023.
Late last week, the Centers for Medicare & Medicaid Services (CMS) finalized a rule that codifies appeal rights for people
KFF recently analyzed Medicare Advantage (MA) data on prior authorization, finding that the rates of requests, or submissions from providers
Prior authorization is one of the processes Medicare Advantage and other private insurance companies use to manage health care utilization
A new study from University of Southern California (USC) researchers shows that Medicare Part D plans have been increasingly restricting
A recent survey from the Commonwealth Fund asked people with Original Medicare (OM) and Medicare Advantage (MA) about their experiences
A new survey from KFF highlights problems people have using their health insurance, with 60% of insured adults reporting that
This week, we at Medicare Rights released our annual Medicare Trends Report, which features key challenges facing people with Medicare
In 2022, Medicare Rights staff and volunteers addressed more than 27,000 questions through its national helpline and professional email channels. Additionally, Medicare Rights’ free and independent online reference tool, Medicare Interactive (MI), provided more than 2.6 million answers for beneficiaries, their caregivers, and professionals. This report features the top helpline trends and highlights the most commonly sought helpline and Medicare Interactive answers, providing a glimpse into the various questions and needs of Medicare beneficiaries, caregivers, and the professionals assisting them in the community in 2022.
The Medicare Rights Center (Medicare Rights) appreciates this opportunity to comment on the Advancing Interoperability and Improving Prior Authorization Processes proposed rule.
Prior authorization is creating an ever-increasing burden on patients. We support many of the Centers for Medicare & Medicaid Services (CMS) provisions in this proposed rule that would reduce this burden by improving processes, timelines, access to information, and communication.
This report features the top helpline trends and highlights the most commonly sought helpline and Medicare Interactive answers, providing a glimpse into the various questions and needs of Medicare beneficiaries, caregivers, and the professionals assisting them in the community in 2023.
Late last week, the Centers for Medicare & Medicaid Services (CMS) finalized a rule that codifies appeal rights for people
KFF recently analyzed Medicare Advantage (MA) data on prior authorization, finding that the rates of requests, or submissions from providers
Prior authorization is one of the processes Medicare Advantage and other private insurance companies use to manage health care utilization
A new study from University of Southern California (USC) researchers shows that Medicare Part D plans have been increasingly restricting
A recent survey from the Commonwealth Fund asked people with Original Medicare (OM) and Medicare Advantage (MA) about their experiences
A new survey from KFF highlights problems people have using their health insurance, with 60% of insured adults reporting that
This week, we at Medicare Rights released our annual Medicare Trends Report, which features key challenges facing people with Medicare
In 2022, Medicare Rights staff and volunteers addressed more than 27,000 questions through its national helpline and professional email channels. Additionally, Medicare Rights’ free and independent online reference tool, Medicare Interactive (MI), provided more than 2.6 million answers for beneficiaries, their caregivers, and professionals. This report features the top helpline trends and highlights the most commonly sought helpline and Medicare Interactive answers, providing a glimpse into the various questions and needs of Medicare beneficiaries, caregivers, and the professionals assisting them in the community in 2022.
The Medicare Rights Center (Medicare Rights) appreciates this opportunity to comment on the Advancing Interoperability and Improving Prior Authorization Processes proposed rule.
Prior authorization is creating an ever-increasing burden on patients. We support many of the Centers for Medicare & Medicaid Services (CMS) provisions in this proposed rule that would reduce this burden by improving processes, timelines, access to information, and communication.
