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.
CMS released a Medicaid interim final rule implementing HR 1's work requirements for expansion enrollees, with states required to have programs operational by January 1, 2027 More...
CDC's new NOFO seeks organizations with infectious disease, antimicrobial resistance, and public health expertise to str… More...
ThriveMore's CEO and Executive Chef share how a clear dining philosophy and resident engagement transformed their dining… More...
Each week LeadingAge provides a newsletter with information across a range of member types and member interests. Have yo… More...
A wave of immigration policy shifts is turning a chronic workforce challenge into an urgent operational risk for aging s… More...
Meet our keynote speaker, a true CHANGE MAKER, and learn more about what we have in store at this year's LeadingAge Wisconsin Annual Conference. More...
Peer networking, leadership growth, and burnout prevention took center stage as nursing home administrators gathered to share solutions and support on… More...
Important: Skilled nursing facilities and assisted living communities must complete the Emergency Preparedness Temporary Shelter “Like Facility” Surve… More...
