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Medicare Advantage insurers ramped up use of technology to deny claims, Senate investigation shows

By STAT News  
   October 17, 2024

The nation's three largest Medicare Advantage insurers increasingly refused to pay for rehabilitative care for seniors in the years after adopting sophisticated technologies to aid in their coverage decisions, a Senate investigation found. UnitedHealth Group, Humana, and CVS Health targeted denials among older adults who were requesting care in nursing homes, inpatient rehab hospitals, and long-term hospitals. As of 2022, those three insurers were turning down roughly a quarter of all requests for post-acute care among their Medicare Advantage enrollees.

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