参议院报告指控主要医疗保险公司以利润为驱动,拒绝提供事后护理服务。 Senate report accuses major Medicare Advantage insurers of profit-driven denial of post-acute care services.

参议院的一份报告指责主要的 Medicare Advantage 保险公司 UnitedHealthcare、Humana 和 CVS 通过经常拒绝对急性期后护理服务的事先授权来优先考虑利润。 A Senate report accuses major Medicare Advantage insurers, UnitedHealthcare, Humana, and CVS, of prioritizing profits by frequently denying prior authorization for post-acute care services. 这些服务的拒绝率大大高于总体率,有些保险人拒绝要求的频率高达16倍。 The denial rates for these services are significantly higher than overall rates, with some insurers denying requests up to 16 times more often. 报告呼吁医疗保健和医疗援助服务中心收集数据,进行审计,并规范在保护病人护理的决策中使用AI。 The report calls on the Centers for Medicare & Medicaid Services to collect data, conduct audits, and regulate the use of AI in decision-making to protect patient care.

October 17, 2024

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