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Medicare Advantage Insurers Made Nearly 50 Million Prior Authorization Determinations in 2023

Almost all (99%) of those enrolled in Medicare Advantage require prior authorization for certain services, like inpatient hospital stays or chemotherapy. This is in contrast to traditional Medicare, which only requires prior authorization for a limited set of services. Prior authorization helps to ensure that healthcare services are necessary before coverage is provided, but can also result in administrative hassle and potential delays in care. A new analysis reveals that Medicare Advantage insurers made roughly 50 million prior authorization decisions in 2023, reflecting a steady increase since 2021.

Source: www.kff.org –

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