Experts: AI Could Make Telehealth Fraud Easier To Detect Than Other Fraud

Artificial intelligence is being effectively used by administration and congressional watchdog agencies to monitor telehealth claims and utilization of health care services to deter fraud, and AI supplemented by human research could make telehealth fraud easier to detect than in-person fraud, a key telehealth lobbyist told Inside Telehealth . The use of AI also makes it easier to detect telehealth fraud than telefraud, according to the HHS Office of Inspector General. Stakeholders lobbying for permanent telehealth reforms hope to convince...
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Oversight Committee Pushes Insurers, PBMs On Contraceptive Coverage

The House oversight committee is the latest Congressional panel to press insurers and pharmacy benefit managers (PBMs) about their compliance with the Affordable Care Act’s mandate to cover all FDA-approved contraceptives with no cost-sharing following reports that companies are shirking the requirements. House oversight committee Chair Carolyn Maloney (D-NY) sent letters to nine PBMs and insurers with a series of questions on their coverage policies and demand responses by June 9. “I am deeply troubled by reports that health plans...
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CMS Issue: 
Inside CMS - 06/02/2022
CMS Volume: 
Vol. 25, No. 22
HEA Issue: 
Health Exchange Alert Weekly Report - 06/01/2022
HEA Volume: 
Vol. 10, No. 22
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New NASEM Committee To Tackle Pediatric Workforce Shortages

A new committee of the National Academies of Sciences, Engineering, and Medicine, in partnership with the Association of Medical School Pediatric Department Chairs, has begun assessing solutions to a significant shortage of pediatric health care workers, especially pediatric subspecialists, which the committee said will impede pediatric patients from receiving quality care and will decrease the field’s overall expertise in the long term. An overall health care workforce shortage has concerned some experts for years, and pandemic-related retirements and resignations drove...
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InsideHealthPolicy.com
CMS Issue: 
Inside CMS - 06/02/2022
CMS Volume: 
Vol. 25, No. 22
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