ICYMI Video: Blumenthal Sounds Alarm on Medicare Advantage Insurers Denying Critical Care for Vulnerable Seniors

[WASHINGTON, D.C.] - In case you missed it, U.S. Senator Richard Blumenthal (D-CT), Chair of the Permanent Subcommittee on Investigations (PSI), released a Majority staff report detailing how the nation's three largest Medicare Advantage insurers-UnitedHealthcare, Humana, and CVS-are intentionally using prior authorization to boost profits by denying-post acute care. In a recent video, Blumenthal highlights how these insurers continue to deny critical treatments and care to vulnerable seniors and the urgent need for accountability and reform of the harmful practices of insurers.

"Insurance companies say that prior authorization is meant to prevent unnecessary medical services. But the Permanent Subcommittee on Investigations has obtained new data and internal documents from the largest Medicare Advantage insurers that discredits these contentions. In fact, despite alarm and criticism in recent years about abuses and excesses, insurers have continued to deny care to vulnerable seniors - simply to make more money," said Blumenthal in the video.

"Reform is imperative and urgent. Federal regulators need better information to identify misconduct and root out abuse. They should make sure that emerging technologies are used to help providers and empower patients, not line the pockets of insurers," continued Blumenthal. "Major improvements to prior authorization procedures are absolutely necessary. Regulators shouldn't have to be looking over insurers' shoulders every time a senior citizen falls or suffers a stroke. But federal oversight and intervention is necessary if these companies can't do better for patients, and put them ahead of profits."

Click HEREfor the full video of PSI Chair Blumenthal discussing the report

In May 2023, PSI launched its investigation by seeking documents and information from UnitedHealthcare, Humana, and CVS-three insurers who together cover nearly 60 percent of all Medicare Advantage enrollees. This report presents new findings based on the more than 280,000 pages of documents obtained from these three companies to date. Through its inquiry, PSI found that between 2019 and 2022, UnitedHealthcare, Humana, and CVS each denied prior authorization requests for post-acute care at far higher rates than they did for other types of care, resulting in diminished access to post-acute care for Medicare Advantage beneficiaries.

The Subcommittee continues to investigate the use of predictive technologies by Medicare Advantages insurers. The full Majority staff report detailing PSI's findings thus far is available here.

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