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Medicare Advantage plans could be denying claims to boost profits, HHS says
Modern Healthcare: The HHS' Office of Inspector General fears that Medicare Advantage plans could be denying needed medical services to maximize profits, according to a new report released Thursday.
When beneficiaries and providers appealed preauthorization and payment denials, Medicare Advantage organizations, or MAOs, overturned 75% of their own denials between 2014 and 2016. They overturned approximately 216,000 denials each year, HHS OIG said.
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