Deciding on the right Medicare coverage means first figuring out whether to go with original Medicare plus a Medigap supplemental policy and a Part D plan, or with a Medicare Advantage and Part D plan ...

There’s no questioning that AI should have governance and guardrails. As much good as it can bring, it also heightens risk.

President Donald Trump’s announcement Wednesday about his plans for artificial intelligence include a push to grow AI ...

Preauthorization is about to enter the lives of many seniors who have chosen traditional Medicare over MA, write former CMS ...

Routinely audit AI tools against clinical guidelines, ... "Bridging The Medicare Risk Gap: How AI Can Enhance Coding Accuracy And Equity", Health Affairs Forefront, March 13, 2025 .

AI can help Medicare detect waste and abuse, but it cannot eliminate the deeper incentives that encourage it. Technology can reveal the symptoms, but only structural reform can treat the disease.

However, here, the court avoids Medicare Act preemption by decoupling the ultimate denial of benefits from the plaintiffs’ allegation that the MAO is using AI inconsistently with its contractual ...

In the world of Medicare Advantage, a disturbing shift is occurring. What began as a noble push toward value-based care has increasingly morphed into an aggressive pursuit of value-based payment ...

UnitedHealth’s Optum working on Medicare risk scoring system that would use AI Trump administration may test AI risk scores in Medicare’s innovation center Manage alerts for this article ...