Medicare Advantage Denial Rates Are a Scandal

CVS denies 80% of long-term care claims. Humana denies 72%. United denies 71%. This isn't utilization management. It's a business model.

The Numbers Are Not in Dispute

Let's start with what we know, because the data is unusually clear.

In June 2026, the Office of Inspector General published two back-to-back reports on Medicare Advantage (MA) denial rates for post-acute care. These weren't advocacy pieces. They weren't patient complaints. They were federal audits of actual claims data from the 19 largest Medicare Advantage Organizations (MAOs), covering Long-Term Care Hospitals (LTCHs), Inpatient Rehabilitation Facilities (IRFs), and Skilled Nursing Facilities (SNFs).

Here's what they found:

The 19 largest MAOs denied 65% of LTCH claims, 54% of IRF claims, and 12% of SNF claims. But the headline numbers obscure the individual insurer performance, which is where it gets damning.

CVS/Aetna denied 80% of LTCH claims and 51% of IRF claims. Humana denied 72% of LTCH claims and 54% of IRF claims. UnitedHealthcare denied 71% of LTCH claims and 66% of IRF claims.

These are not marginal facilities. Long-Term Care Hospitals serve patie…