Proposed Rule Would Improve Medicare Advantage Prior Authorization and Transparency
January 30, 2025
This week, Medicare Rights submitted comments in response to the annual Medicare Advantage (MA) and Part D proposed rule for
📢 Action Needed: Tell Congress to Protect Federal Funding
Denials and Appeals
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.
Medicare Rights Helpline Trends Report Highlights Beneficiary Challenges and Opportunities for Reform
January 16, 2025
This week, the Medicare Rights Center released our annual helpline trends report, Medicare Trends and Recommendations: An Analysis of 2023 Call
Medicare Rights Center Highlights Top Challenges for Medicare Beneficiaries in 2023 Trends Report
January 14, 2025
New York, NY—The Medicare Rights Center (Medicare Rights) released its annual helpline trends report, Medicare Trends and Recommendations: An Analysis of
Medicare Trends and Recommendations
January 13, 2025
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.
Final Rule Codifies Observation Stay Appeal Rights
October 17, 2024
Late last week, the Centers for Medicare & Medicaid Services (CMS) finalized a rule that codifies appeal rights for people
Medicare Advantage Denials Increased Before the Implementation of New Prior Authorization Rules
September 26, 2024
KFF recently analyzed Medicare Advantage (MA) data on prior authorization, finding that the rates of requests, or submissions from providers
Final Rules on Medicare Advantage Prior Authorization Offer Improvements, but More Change is Needed
May 30, 2024
Prior authorization is one of the processes Medicare Advantage and other private insurance companies use to manage health care utilization
Study Shows Part D Plans Ratcheting Up Restrictions on Coverage
March 14, 2024
A new study from University of Southern California (USC) researchers shows that Medicare Part D plans have been increasingly restricting
Coverage Experiences Vary for Original Medicare and Medicare Advantage Enrollees
February 29, 2024
A recent survey from the Commonwealth Fund asked people with Original Medicare (OM) and Medicare Advantage (MA) about their experiences
Denied Insurance Claims Cause Issues for People with All Forms of Health Coverage
October 19, 2023
A new survey from KFF highlights problems people have using their health insurance, with 60% of insured adults reporting that
Proposed Rule Would Improve Medicare Advantage Prior Authorization and Transparency
January 30, 2025
This week, Medicare Rights submitted comments in response to the annual Medicare Advantage (MA) and Part D proposed rule for
Medicare Rights Helpline Trends Report Highlights Beneficiary Challenges and Opportunities for Reform
January 16, 2025
This week, the Medicare Rights Center released our annual helpline trends report, Medicare Trends and Recommendations: An Analysis of 2023 Call
Medicare Rights Center Highlights Top Challenges for Medicare Beneficiaries in 2023 Trends Report
January 14, 2025
New York, NY—The Medicare Rights Center (Medicare Rights) released its annual helpline trends report, Medicare Trends and Recommendations: An Analysis of
Medicare Trends and Recommendations
January 13, 2025
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.
Final Rule Codifies Observation Stay Appeal Rights
October 17, 2024
Late last week, the Centers for Medicare & Medicaid Services (CMS) finalized a rule that codifies appeal rights for people
Medicare Advantage Denials Increased Before the Implementation of New Prior Authorization Rules
September 26, 2024
KFF recently analyzed Medicare Advantage (MA) data on prior authorization, finding that the rates of requests, or submissions from providers
Final Rules on Medicare Advantage Prior Authorization Offer Improvements, but More Change is Needed
May 30, 2024
Prior authorization is one of the processes Medicare Advantage and other private insurance companies use to manage health care utilization
Study Shows Part D Plans Ratcheting Up Restrictions on Coverage
March 14, 2024
A new study from University of Southern California (USC) researchers shows that Medicare Part D plans have been increasingly restricting
Coverage Experiences Vary for Original Medicare and Medicare Advantage Enrollees
February 29, 2024
A recent survey from the Commonwealth Fund asked people with Original Medicare (OM) and Medicare Advantage (MA) about their experiences
Denied Insurance Claims Cause Issues for People with All Forms of Health Coverage
October 19, 2023
A new survey from KFF highlights problems people have using their health insurance, with 60% of insured adults reporting that