Alice Bers, Elder Law Attorney with the Center for Medicare Advocacy and Community Legal Aid in Western MA, wrote a guest column for the Greenfield Recorder (July 21, 2026), encouraging enrollees of Medicare Advantage Plans and their advocates to appeal denials. Odds are in favor of those who appeal. Alice notes in her column: “The June 2026 report from the U.S. Department of Health and Human Services’ Office of Inspector General found that when patients and providers appeal Medicare Advantage denials of prior authorizations for nursing facility care, they win 95% of the time.” This advice is for prior authorization denials and denials of coverage in general–not just those connected to nursing facility care. Read the full article for more detail and if you want to make an appeal, consider getting help from the Massachusetts Medicare Advocacy Project, of which Alice is the Director.
