Medicare Advantage Plans Must Automatically Review All Coverage Denials.
This bill mandates that Medicare Advantage insurance plans must automatically reconsider every decision to deny coverage for medical services. This removes the current requirement for the enrollee to file a formal request for reconsideration, simplifying the appeal process significantly. The change aims to ensure beneficiaries receive a faster, less burdensome review of denied claims.
Key points
Medicare Advantage plans are required to automatically review all coverage denial decisions.
Enrollees no longer need to file a request for the initial reconsideration of a denied claim.
The change streamlines the process for appealing unfavorable insurance decisions, benefiting patients.
Introduced
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