New Report from OIG re: MCO Prior Auth Denial Rates

July 19, 2023

As the NYS Council continues to discuss our highest priorities for the coming Legislative Session, a new Report issued by the federal Office of the Inspector General (OIG) underscores the widespread problem of prior authorization denials for care in state programs overseen by MCOs across the country.   In this instance, limited state oversight is linked to OIG findings that one in eight requests for prior authorization are denied by MCOs, with some states having much higher denial rates.

See attached for the new Report by the OIG.