ICYMI: Congresswoman Schrier Grills Healthcare CEOs for Abusing Prior Authorization, Delaying, and Denying Health Care

WASHINGTON, DC – At an Energy and Commerce Health Subcommittee hearing this week, Congresswoman Kim Schrier, M.D. (WA-08), grilled health insurance CEOs for their companies’ repeated abuse of prior authorization to delay and deny patients' health care, especially those on Medicare Advantage. 

 “Your companies are charging more, paying less, and then delaying or even denying care due to abusive demands for prior authorizations… Particularly when it comes to Medicare Advantage, not only do you delay that care with prior authorization demands, you sometimes flat-out deny claims after the services are already rendered,” said Congresswoman Schrier, M.D. 

 Congresswoman Schrier took UnitedHealth Group CEO Stephen Hemsley to task for his company’s conduct – UnitedHealth has a history of Medicare Advantage abuse, demanding more prior authorization than other insurance companies that take care of Medicare Advantage patients. Approximately 80% of UnitedHealth patients who appeal their denied claims have their denials partially or fully reversed, leading to serious questions as to why their claims were originally denied. 

 “To the rest of us, this looks like your business model – it looks like you bet on wearing patients down, on them not appealing, and then they either decide to just eat the costs or they die before they get the care that they need,” said Congresswoman Schrier, M.D. “My constituents are sick of it, we’re sick of it, doctors are sick of it, and people deserve better. We need Medicare Advantage reform now.”

 To watch Congresswoman Schrier’s full remarks, click here.