This company has taken AI to the next level. Suddenly, you’ll understand how much more helpful an AI agent can be than a call ...

Medicare Advantage plans have drawn the ire of lawmakers for aggressive coding. Investigations are underway. Some hope ...

Although the 2024 Medicare Advantage final rule provided some guidance around payment denials and practices, the AHA emphasized that AI-driven denials remain a serious issue. In its guidance ...

CMS said in February that Medicare Advantage insurers can use AI and other technologies in ... by claiming that these tools are mere 'guidance,'" the lawmakers wrote to Brooks-LaSure.

In the letter addressed to Chiquita Brooks-LaSure, administrator of the Centers for Medicare ... ‘guidance.’ Given that we do not know what inputs are used for the algorithms and AI tools ...

As Medicare payment models evolve ... health care organizations should: Routinely audit AI tools against clinical guidelines, regulatory standards, and known sources of bias.

Health care experts are skeptical. “The track record of using AI or algorithms in Medicare Advantage prior authorization and coverage decisions does not inspire confidence that such technology ...

The Centers for Medicare and Medicaid Services is asking organizations ... contracts for the acquisition of AI systems and services align with” OMB’s earlier AI guidance within 180 days of its ...

Humana has made a minority investment in Healthpilot, an AI-enabled platform that makes it easier for people to search for and enroll in Medicare ... consumer-specific guidance that assists ...