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Medicare Advantage Regulatory Scrutiny Keeps Pace with Growth: OIG Report Examines Prior Authorization and Payment Denial Errors
On April 28, 2022, the United States Department of Health and Human Services’ Office of Inspector General (“OIG”) issued a report finding that 15 of the largest Medicare Advantage Organizations (“MAOs”) in the United States have at times denied or delayed beneficiary access to care and provider payment requests for services that met Medicare coverage and MAO billing rules (the “Report”).