In August, the U.S. Department of Health and Human Services Office of Inspector General (OIG) released a new work plan announcing oversight of Medicare and Medicaid managed care. The OIG noted that a primary goal is to “promote access to care for people enrolled in managed care,” particularly since access to services is the foundational principle for care, including the timeliness of care. The OIG noted that harmful delays in care could result from lengthy prior authorization processes, citing previous reports finding that Medicare Advantage and Medicaid Managed Care plans used prior authorization to inappropriately deny medical care.
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