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The Medicare device coverage gap delays life-saving treatment for seniors
- Walnut Hill Medical released the MAD Study on June 3, 2025, revealing Medicare Advantage plans delayed or denied PNS therapy for 1,210 patients in 2024.
- The study found 29% of patients faced first-attempt denials, more than twice the 13% denial rate meeting coverage criteria identified by the 2022 OIG report.
- Peripheral Nerve Stimulation is a minimally invasive, FDA-cleared, non-opioid option for chronic pain management; however, nearly one-third of patients discontinued pursuing treatment following an initial denial.
- Chris Hanna, CEO of Walnut Hill, emphasized that prior authorization has evolved beyond a simple administrative step and is now being used as a tool to limit access to care, with Medicare Advantage plans withholding $6.2 million in treatment payments.
- The study calls on legislators to enhance the transparency and accountability measures within the 2025 bipartisan legislation aimed at ensuring seniors receive timely healthcare access, addressing issues related to care denials and delays.
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Journal Gazette & Times-Courier+22 Reposted by 22 other sources
Walnut Hill Study Exposes Systemic Medicare Advantage Barriers Causing Delays, Denials, and Patient Abandonment
DALLAS, June 3, 2025 /PRNewswire/ -- Walnut Hill Medical has released findings from its MAD (Medicare Advantage Denial) Study, revealing that Medicare Advantage plans are systematically delaying or denying access to a non-opioid, non-steroidal chronic pain treatment: Peripheral Nerve Stimulation…
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Total News Sources24
Leaning Left1Leaning Right0Center10Last UpdatedBias Distribution91% Center
Bias Distribution
- 91% of the sources are Center
91% Center
C 91%
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