Congress Urges Medicare to Monitor Use of AI in Prior Authorization

Summary
In a letter to the Centers for Medicare & Medicaid Services (CMS), more than 50 lawmakers in both the House and Senate expressed concern that Medicare Advantage plans are using AI in a way that results in denying care erroneously and contradicting provider assessment findings. They urge CMS to proactively monitor plan use of AI-driven tools and require a higher burden of proof for denying coverage of care when AI is used.
Impacted Sectors
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