Federal probe finds private Medicare Advantage plans deny rehab care, then reverse on appeal
read at STAT ↗RegulatoryNegative
A federal investigation has revealed that the nation's largest Medicare Advantage insurers routinely deny post-acute rehabilitative services to older and disabled beneficiaries.
The review found that UnitedHealth Group's NaviHealth and Humana denied such care at rates higher than other plans, but many of those denials were later overturned after patients filed appeals.
Investigators say the pattern suggests insurers are using denials to increase profits, forcing seniors to battle for doctor-recommended treatment.
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This writeup was produced by pharmadog from original reporting by STAT.
Original headline: “STAT+: Private Medicare plans erect barriers to rehab care in pursuit of profit, federal investigators find”
read at STAT ↗600 words · retrieved Jun 11
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