Congress To CMS: Step Up Oversight Of AI, Algorithms In MA Prior Authorization

By Dorothy Mills-Gregg / June 25, 2024 at 7:20 PM
CMS needs to be more proactive in monitoring Medicare Advantage plans’ use of artificial intelligence and algorithmic software when processing prior authorizations, more than 50 lawmakers in both the House and Senate said in a letter to the agency Tuesday (June 25) . While the lawmakers say they’re pleased with CMS’ recent rules on prior authorization , they are still concerned that MA plans are using AI that’s erroneously denying care and contradicting provider assessment findings. They cite the class...


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