Tuesday 30 October 2018

Medicare Advantage Investigation by OIG

Medicare Advantage Investigation by OIG | Denials For Profit

The Office of Inspector General for the Department of Health and Human Services (OIG) has concluded its investigation into denials of care with Medicare Advantage Organizations (MAO's) and the findings
are quite disturbing. Routine denials of care are happening at an alarming rate and the OIG finds that profit is the motive. When the member of the Medicare Advantage plan has appealed the denials they were
overturned in up to 75% of the cases. Members who do not appeal are denied any payment for services that were not approved.
Medicare Advantage Investigation by OIG