Becker's Healthcare June 25, 2024
Lawmakers are pushing CMS to do more to prevent misuse of artificial intelligence by Medicare Advantage plans.
A group of 51 lawmakers signed a letter to CMS Administrator Chiquita Brooks-LaSure on June 25, asking the agency to implement more stringent oversight regarding the technology.
In November, families of two UnitedHealthcare Medicare Advantage members sued the company, alleging naviHealth, an AI algorithm, wrongfully denied the men post-acute care. An Optum spokesperson previously told Becker’s the product is not used to make coverage determinations.
“We remain concerned about MA plans’ use of prior authorization, specifically their ongoing use of artificial intelligence algorithmic software to guide coverage decisions,” the lawmakers wrote. “Plans continue to use AI tools to erroneously deny...
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