HEN Sends Letter to HHS Secretary Becerra and CMS Administrator Brooks-LaSure On Coverage Denials
July 3, 2024
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Wednesday, July 3, 2024
Secretary Xavier Becerra
Department of Health and Human Services
200 Independence Avenue, S.W.
Washington, D.C. 20201
Administrator Chiquita Brooks-LaSure
U.S. Centers for Medicare & Medicaid Services
7500 Security Boulevard
Baltimore, MD 21244
Dear Secretary Becerra and Administrator Brooks-LaSure,
We are writing to express our deep concern regarding the widespread and increasing practice of commercial
insurance companies denying claims for millions of American patients. Claims are often denied without cause
and lead to financial and emotional distress for individuals already burdened with the stress of healthcare
issues, especially in our most vulnerable communities.
According to a KFF analysis, insurance companies, on average, deny 1 in 5 claims, with one insurer rejecting 49
percent and another rejecting a shocking 80 percent. Cigna, a health insurance company with 20 million
medical customers and revenue of $195 billion in 2023, was caught last year denying claims without even
This problem extends to Medicare Advantage plans, which were created to offer more choice and
comprehensive benefits and now cover more than half of all Medicare beneficiaries but are now inundated
with prior authorization requirements and coverage denials.
In fact, according to KFF, as many as 1.5 million Medicare Advantage prior authorizations are improperly denied
each year, and the number is only growing. According to the Inspector General for the Department of Health
and Human Services, there were 640,000 denials in 2019 compared to 2 million in 2021.
UnitedHealthcare, the nation's largest health insurer with more than 50 million customers, the largest share of
Medicare Advantage enrollment (29 percent), and a revenue of $371.6 billion in 2023 denies at least 2 million
Medicare Advantage prior authorization claims each year. They were sued last year for using an artificial
intelligence algorithm to wrongfully deny elderly patients care under Medicare Advantage insurance plans. The
algorithm was known by the company to have a 90 percent error rate and resulted in patients being
prematurely kicked out of care facilities.
Unfortunately, yet unsurprisingly, insurance denials and prior authorization requirements affect minority, and
lower-income populations at a much higher rate. A 2022 study found that Black cancer patients were three
times more likely to be denied health insurance compared to white patients.
Insurance companies have gotten away with making hundreds of billions of dollars off the backs of patients,
providers, and hospitals for too long. It is time that we put patients over profits and hold these goliaths
accountable.
Sincerely,
Edolphus Towns, Former Member of CongressThe Healthcare Equality Network
Black Women’s Health Imperative
The Frederick Douglass Foundation
Southern Christan Leadership Conference
Dr. Benjamin Chavis, Jr.
Dr. Julianne Malveaux
CC:
Senator Bernie Sanders
Senator Elizabeth Warren
Congressional Black Caucus:
Del. Eleanor Holmes Norton
Rep. Maxine Waters
Rep. Sanford D. Bishop
Rep. James E. Clyburn
Rep. Bobby Scott
Rep. Bernie Thompson
Rep. Sheila Jackson-Lee
Rep. Danny K. Davis
Rep. Gregory W. Meeks
Rep. Barbara Lee
Rep. David Scott
Rep. Emanuel Cleaver, II
Rep. Al Green
Rep. Gwen Moore
Rep. Yvette D. Clarke
Rep. Hank Johnson
Rep. André Carson
Rep. Terri Sewell
Rep. Frederica S. Wilson
Rep. Donald M. Payne, JR.
Rep. Joyce Beatty
Rep. Hakeem Jeffries
Rep. Marc Veasey
Rep. Robin Kelly
Sen. Cory Booker
Rep. Alma Adams
Del. Stacey Plaskett
Rep. Bonnie Watson Coleman
Rep. Dwight Evans
Rep. Lisa Blunt Rochester
Rep. Steven Horsford
Rep. Colin Allred
Rep. Jahana Hayes
Rep. Lucy McBath
Rep. Joe Neguse
Rep. Ilhan OmarRep. Ayanna Pressley
Rep. Lauren Underwood
Rep. Kweisi Mfume
Rep. Nikema Williams
Rep. Cori Bush
Rep. Jamall Bowman
Rep. Ritchie Torres
Rep. Marilyn Strickland
Sen. Raphael Warnock
Rep. Troy Carter
Rep. Shontel Brown
Rep Sheila Cherfilus-McCormick
Rep. Jasmine Crockett
Rep. Don Davis
Rep. Valerie Foushee
Rep. Maxwell Alejandro Frost
Rep. Glenn Ivey
Rep. Jonathan Jackson
Rep. Sydney Kamlager0Dove
Rep. Summer Lee
Rep. Emilia Sykes
Rep. Jennifer McClellan
Sen. Laphonza Butler
Rep. Gabe Amo
