New Reports: Over Half of the Time, Medicare Managed Care Companies Denied Enrollees Long Term & Rehab Hospital Care – Plus, Concerns Over Skilled Nursing Denials Requests

LEIE Updated with
May 2026 Exclusions

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June 11, 2026: Medicare Advantage Organizations Overturned Nearly All Appealed Prior Authorization Denials for Skilled Nursing Facility Admission, Raising Concerns About Initial Denials; The Three Largest Medicare Advantage Organizations Denied Requests for Long-Term Acute Care and Inpatient Rehabilitation at Some of the Highest Rates; New Corporate Integrity Agreement: Community Care Health Network LLC d/b/a Matrix Medical Network

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June 10, 2026; U.S. Department of Justice: Ahold Delhaize USA Inc. to Pay $40M for Allegedly Reporting Inflated Drug Prices on Claims to Federal Healthcare Programs
June 10, 2026; U.S. Attorney's Office, Northern District of California: San Francisco Company Agrees to Pay Over Three Million Dollars to Resolve Allegations That They Submitted False Claims for Healthcare Payments
June 10, 2026; U.S. Attorney's Office, Northern District of New York: Sarcone Leads Revival of NDNY Health Care Fraud Task Force

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