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| 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.
Following the Supreme Court's Haiti TPS ruling, LeadingAge advises members to await DHS guidance, monitor USCIS resources, and encourage affected employees to seek immigration coun… More...
Governors and AGs from 25 states filed suit June 29 challenging CMS's Medicaid work requirements rule as exceeding statu… More...
A federal court stayed key parts of the RISE final rule, prompting an interim list of professional degree programs — inc… More...
CMS is reducing FY 2026 federal monitoring surveys due to the government shutdown, but will still survey at least 5 nurs… More...
CDC has issued a "Think Ebola" factsheet to help providers identify potential cases among patients or staff who traveled… More...
Start your conference by connecting with peers in your profession. Profession-based networking meetings are just one of many opportunities to build la… More...
Wisconsin’s assisted living facilities grew in 2025, with more residents, new quality initiatives, and updated regulations. Discover key trends, enfor… More...
The Wisconsin Dept. of Health Services Bureau of Assisted Living is rolling out new tools to make the survey process more collaborative, efficient and… More...
