April 2022: Some Medicare Advantage Organization Denials of Prior Authorization Requests Raise Concerns About Beneficiary Access to Medically Necessary Care

With there being the potential concern of MAOs having the ability to increase profits by denying payments and access to services to providers, the OIG conducted this review from a random sample of 250 denials of prior authorization requests and 250 payment denials issued by 15 of the largest MAOs during the month of June 2019.

Report in Brief 

Office of Inspector General: MAOs & Pre Authorization Requests