STAT+: Medicare Advantage plans will have to stop denying required care, federal officials say
The Biden administration is moving forward with proposals that would crack down on Medicare Advantage insurers that deny care inappropriately — including if companies use algorithms to turn down coverage.
Starting next year, Medicare Advantage plans cannot reject coverage of procedures, prescription drugs, tests, or supplies that would otherwise be covered if someone were enrolled in the traditional Medicare program, according to final regulations issued Wednesday. Medicare Advantage, the privatized version of the original Medicare program, covers more than 31 million older adults and people with disabilities in insurance plans.
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