Medicare Will Require Prior Approval for Certain Procedures. A pilot program in six states will use a tactic employed by private insurers that has been heavily criticized for delaying and denying medical care.

    https://www.nytimes.com/2025/08/28/health/medicare-prior-approval-health-care.html

    Posted by coolbern

    4 Comments

    1. PracticalChipmunk789 on

      Deny, defend, depose. Fuck the US scam called healthcare. Deathcare is far more fitting.

    2. >The A.I. companies selected to oversee the program would have a strong financial incentive to deny claims. Medicare plans to pay them a share of the savings generated from rejections.

      The way it needs to work is, they need a penalty of 3 times or 5 times or whatever they get for a denial for any denials reversed on medical necessity so that the denials are high quality. They need a disincentive for lousy denials.

      If that is missing, it’s rigged.

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