Healthcare Finance News June 26, 2024
“Plans continue to use AI tools to erroneously deny care and contradict provider assessment findings,” lawmakers say.
A bipartisan group of lawmakers is asking the Centers for Medicare and Medicaid Services Administrator Chiquita Brooks-LaSure for greater oversight of Medicare Advantage coverage decisions.
Over 50 House Representatives and Senators sent a letter on June 25 to Brooks-LaSure saying they are concerned about MA plans’ use of prior authorization, specifically the ongoing use of artificial intelligence and algorithmic software by insurers to guide coverage decisions.
“Plans continue to use AI tools to erroneously deny care and contradict provider assessment findings,” the lawmakers said.
WHY THIS MATTERS
The lawmakers cited a class action lawsuit brought against UnitedHealth Group last year...
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