With more than half of all eligible Medicare beneficiaries enrolled in a Medicare Advantage (MA) plan, a survey from the American Health Care Association (AHCA) finds that MA plans are denying or delaying medically necessary post-acute care, often against medical professionals’ recommendations, on a daily and weekly basis.  

The results of the survey, conducted by AHCA in May 2025 of 363 nursing home providers, adds to existing research that finds post-acute care is disproportionately impacted by MA prior authorizations. Additional research has also found that while a small share of denied prior-authorization requests are appealed, most appeals are partially or fully overturned.

“This constant hoop-jumping is resulting in too many skilled nursing patients being discharged too soon against medical advice, threatening their recovery,” said Clif Porter, president and CEO of AHCA. “We want to make sure Medicare Advantage plans are providing the therapy benefits our seniors were promised and are not leaving important—sometimes lifesaving—medical decisions to AI or insurers without appropriate guardrails and oversight. There is a better way to approach coverage decisions: where we put patients and their care team at the center of every decision.” ​