UnitedHealthcare Medicare Denials Still High
UnitedHealthcare Medicare Advantage shows highest drug denial rates in 2024–2025. Delays, AI denials, and DOJ scrutiny raise concerns for providers.
Roberta L. Buell is a Principal at onPoint Oncology Inc., specializing in oncology reimbursement. With over 23 years of experience in billing, coding, and drug therapy reimbursement, she's a nationally recognized expert and frequent speaker on regulatory and reimbursement issues. Bobbi has led more than 600 seminars since 1991 and currently serves as content director for focalPoint® and assistPoint®. Learn more about Bobbi here .
UnitedHealthcare Medicare Advantage shows highest drug denial rates in 2024–2025. Delays, AI denials, and DOJ scrutiny raise concerns for providers.
Preview the 2026 ICD-10-CM code updates: 500+ proposed changes across specialties, from diabetes and cancer to cannabis hyperemesis and Gulf War illness.
CMS finalizes 2026 Medicare Advantage and Part D rule: no AI limits or obesity drug coverage, but IRA updates, D-SNP changes, and a 5.06% payment increase remain.
CMS proposes 2.4% hospital pay increase for FY 2026, updates to quality programs, and ends equity measures. Read key IPPS rule changes and hospital impacts.
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The Comparative Report puts ASP, the Medicare payment limit, WAC and AWP for up to 15 drugs on one timeline. Ten-plus years of monthly history, per HCPCS unit.
Included with BuyandBill Pro for $37/month billed annually.
Trastuzumab class, seven products
Actual published ASP, Jan 2015 to Aug 2026.