Medicare Advantage Transparency: Requiring Disclosure of Prior Authorization Denial Rates.
This bill mandates that advertisements for Medicare Advantage plans must include specific data on prior authorization denials. Citizens will gain crucial insight into how often a plan initially denies coverage for medical services and the time it takes to appeal and overturn those denials. This aims to help beneficiaries make better-informed decisions when selecting their health coverage.
Key points
Medicare Advantage advertisements must disclose the total number of prior authorization requests denied in the previous year.
Plans must also reveal how many of those denials were later approved after reconsideration or appeal.
The average number of days required to approve a service after its initial denial must be publicly stated.
Status:
Introduced
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