Click here to view or download the full letter.

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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

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Administrator Chiquita Brooks-LaSure

U.S. Centers for Medicare & Medicaid Services

7500 Security Boulevard

Baltimore, MD 21244

 

 

Dear Secretary Becerra and Administrator Brooks-LaSure,

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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.

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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

opening the patient’s file.

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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.

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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.

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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.

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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.

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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.

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Sincerely,

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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