Becker's Healthcare February 8, 2024
Algorithms and artificial intelligence-powered software tools can be used to support Medicare Advantage plans in making coverage decisions for members, but payers are still bound by CMS’ internal benefits requirements and nondiscrimination rules under the ACA, the agency said in guidance to insurers regarding its final 2024 MA rule.
“We are concerned that algorithms and many new artificial intelligence technologies can exacerbate discrimination and bias,” the agency wrote Feb. 6. “MA organizations should, prior to implementing an algorithm or software tool, ensure that the tool is not perpetuating or exacerbating existing bias, or introducing new biases.”
The guidance comes as scrutiny of payers’ use of AI increased in 2023. UnitedHealthcare, Humana and Cigna are facing lawsuits alleging they used...
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