Medicare Appeals See Early-Year Processing Focus

January 2026 sees major Medicare administrative delays due to new Part D rules, federal oversight pilots, and seasonal healthcare demands. Prescription drug appeals surge as formularies narrow, prior authorizations cause denials in select states, and skilled nursing facility coverage appeals slow amid compliance tasks. Inpatient stay audits, durable medical equipment billing, and surprise out-of-network dispute resolutions face significant backlogs, causing prolonged patient billing uncertainties. Immediate, well-documented appeals are crucial.