Here are examples of what the new report found that highlight the serious flaws with MAPs. They often denied medically necessary care to beneficiaries and payments to doctors that met Medicare coverage rules. OIG found that 13% of prior authorization requests that were denied met Medicare coverage rules, as did 18% of physician payment requests that were turned down.
For every 76-year-old who can pull off this type of resistance, there are many more who would not have been so lucky. Time takes its toll, and the older we get the less capable we are of defending ourselves as this man did. Imagine if this man had failed in his struggle. And imagine if that money was all he had to put food on his table for the week. And imagine if those criminals had been more persistent and more violent, and this man had ended up in the hospital; or worse.