Medicare Advantage Insurers Deny Prior Authorization Requests for Post Acute Care at Substantially Higher Rates Than the Overall Denial Rate Authors: Jeannie Fuglesten Biniek, Meredith Freed, and Juliette Cubanski Published: Jul 6, 2026

https://www.kff.org/medicare/medicare-advantage-insurers-deny-prior-authorization-requests-for-post-acute-care-at-substantially-higher-rates-than-the-overall-denial-rate/?utm_campaign=KFF-This-Week&utm_medium=email&_hsenc=p2ANqtz-8q_Nuo4kyAmqNj68572UGnfLqBZFQPZd8ljnqyHJfTVvGbK95eRDJcVyQFT9SrqxbL87EvhyUnfYmwmpvmVbI4VqMf5Q&_hsmi=427848216&utm_content=427848216&utm_source=hs_email Prior authorization practices by health insurers have come under scrutiny in recent years, in part spurred by the public sentiment that delays and denials of care are a problem. According to KFF polling, about seven in ten insured adults say prior authorization is a burden. New evidence from the Office of Inspector General (OIG) within the Department of Health and Human Services documents the high rate of denials of prior authorization requests for certain post-acute care services in Medicare Advantage plans, which now enroll more than half of all Medicare beneficiaries.