Pallone Announces Inquiry into High Rates of Denial of Care by Medicaid Managed Care Plans

 Energy and Commerce Committee Ranking Member Frank Pallone, Jr. (D-NJ) released the following statement today announcing an inquiry into high rates of prior authorization denials by Medicaid managed care health insurance plans: 

“I’m deeply troubled by reports that Medicaid managed care plans denied an average of one out of every eight requests for treatment, more than double the rate of service denials in Medicare Advantage.  

“Medicaid is a lifeline for over 80 million people, including children, people with disabilities, seniors, and hardworking families. This report strongly suggests that some private insurance plans, which states have contracted with to provide health care coverage to their residents, may be improperly denying access to critical services in order to maximize their profits.  

“I applaud the Office of the Inspector General for their important work on this report and for shining a light on these alarming practices. I will be contacting each of these health insurance companies directly for additional information and questions regarding their prior authorization practices. It is essential that these state contracted plans are upholding their responsibility to patients and their families.” 

Last month, the Health and Human Services Office of the Inspector General (OIG) released an alarming report that raised concerns that some people enrolled in Medicaid managed care may not be receiving all medically necessary health care services due to high rates of prior authorization denials by the insurance plans. 

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