Medicare Advantage Plans Denied a Larger Share of Prior Authorization Requests in 2022 Than in Prior Years

Medicare Advantage plans denied 7.4% of prior authorization requests in 2022, a substantial increase from previous years. Only 9.9% of denied requests were appealed, yet 83.2% of these appeals resulted in reversed decisions. The Biden administration has finalized rules to improve the transparency and timeliness of prior authorization decisions and assess their impact on people with certain social vulnerabilities.