Attention: You are using an outdated browser, device or you do not have the latest version of JavaScript downloaded and so this website may not work as expected. Please download the latest software or switch device to avoid further issues.
| 18 June 2026 | |
| LeadingAge National Updates |
A June 11 OIG report found Medicare Advantage Organizations (MAOs) denied 12% of SNF prior authorization requests, with wide variation across plans. Critically, 95% of appealed denials were overturned, indicating most initial denials were inappropriate. Long-stay nursing home residents fared worse, facing denials 40% of the time versus 11% for other enrollees. Third-party contractor naviHealth denied SNF care at a 14% rate, with 97% of those denials overturned on appeal.
LeadingAge had requested the OIG review and continues advocating for MAO accountability, standardized prior authorization processes, and expedited appeals. CMS neither concurred nor disagreed with OIG's recommendations, leaving the path forward uncertain.
The Guilding an Improved Dementia Experience (GUIDE) model can support quality of life for individuals with dementia and their caregivers. Access a free video and infographic to le… More...
A recent ruling relating to the integration mandate is raising concerns about the future of community-based supports for… More...
A new SBA Office of Advocacy letter warns that CMS's proposed CY27 payment rule could increase burdens on small healthca… More...
Could technology help solve your community’s biggest care access challenges? Join a no-cost cohort to explore solutions … More...
Congress needs to hear from aging services stakeholders that now is the time to bring Medicare Advantage reforms over th… More...
One conference next week, and we’re already planning the next! Meet our 2027 theme, The Power of Now, and submit your proposal through November to hel… More...
In a crowded, competitive labor market, Morrow Home Community used strategic construction planning and their culture of care to create a real edge. More...
Change doesn't happen by chance—it happens because leaders are willing to learn, collaborate, & grow. Join us Sept 29–Oct 1 in Green Bay for practical… More...
