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Certain insurers must now publicly report specific prior authorization metrics, but the new data offer limited insight, providing no information on what types of services are being approved and denied or why as well as no data on prescription drugs.
In February, the Trump administration launched TrumpRx, a government website that provides prescription drug discounts to consumers. This brief examines issues that may impact consumers, especially those with private insurance, who access drug discounts through TrumpRx.
This brief analyzes federal transparency data published by CMS on claims denials and appeals for Marketplace plan offered on HealthCare.gov in 2024, and finds insurers denied 19% of in-network claims. Consumers rarely appeal denied claims.
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