{"id":22437,"date":"2024-02-09T07:56:48","date_gmt":"2024-02-09T12:56:48","guid":{"rendered":"https:\/\/medicarereport.org\/?p=22437"},"modified":"2024-02-09T07:56:50","modified_gmt":"2024-02-09T12:56:50","slug":"medicare-advantage-ai-under-more-fire-in-washington","status":"publish","type":"post","link":"https:\/\/medicarereport.org\/?p=22437","title":{"rendered":"Medicare Advantage AI under more fire in Washington"},"content":{"rendered":"\n<p>(By Rylee Wilson for <em>Becker&#8217;s Hospital Review<\/em>)<\/p>\n\n\n\n<p>New guardrails for Medicare Advantage plans&#8217; use of AI may not be clear enough, experts told members of the Senate Finance Committee.<\/p>\n\n\n\n<p>CMS sent a message to Medicare Advantage plans Feb. 6, clarifying how new prior authorization rules set forth by the agency apply to AI. The agency wrote that AI programs can be used to assist in coverage determinations, but it is the plans&#8217; responsibility to &#8220;ensure that the algorithm or artificial intelligence complies with all applicable rules for how coverage determinations by MA organizations are made.&#8221;  Continue reading <a href=\"https:\/\/www.beckerspayer.com\/payer\/medicare-advantage-ai-under-more-fire-in-washington.html\" data-type=\"link\" data-id=\"https:\/\/www.beckerspayer.com\/payer\/medicare-advantage-ai-under-more-fire-in-washington.html\">here&#8230;<\/a><\/p>\n\n\n\n<p><img loading=\"lazy\" decoding=\"async\" width=\"150\" height=\"100\" class=\"wp-image-7905\" style=\"width: 150px;\" src=\"https:\/\/medicarereport.org\/wp-content\/uploads\/2017\/08\/dreamstime_m_92701316AI-artificial-intelligence-cybernetics.jpg\" alt=\"\" srcset=\"https:\/\/medicarereport.org\/wp-content\/uploads\/2017\/08\/dreamstime_m_92701316AI-artificial-intelligence-cybernetics.jpg 2121w, https:\/\/medicarereport.org\/wp-content\/uploads\/2017\/08\/dreamstime_m_92701316AI-artificial-intelligence-cybernetics-300x200.jpg 300w, https:\/\/medicarereport.org\/wp-content\/uploads\/2017\/08\/dreamstime_m_92701316AI-artificial-intelligence-cybernetics-768x512.jpg 768w, https:\/\/medicarereport.org\/wp-content\/uploads\/2017\/08\/dreamstime_m_92701316AI-artificial-intelligence-cybernetics-1024x683.jpg 1024w\" sizes=\"auto, (max-width: 150px) 100vw, 150px\" \/><\/p>\n\n\n\n<p class=\"has-small-font-size\"><strong>Notice:&nbsp;<\/strong>The link provided above connects readers to the full content of the posted article. The URL (internet address) for this link is valid on the posted date; medicarereport.org cannot guarantee the duration of the link\u2019s validity. Also, the opinions expressed in these postings are the viewpoints of the original source and are not explicitly endorsed by AMAC, Inc.; the AMAC Foundation, Inc.; or medicarereport.org.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>(By Rylee Wilson for Becker&#8217;s Hospital Review) New guardrails for Medicare Advantage plans&#8217; use of AI may not be clear<\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[23,32,9],"tags":[153,80,62,796,94],"class_list":["post-22437","post","type-post","status-publish","format-standard","hentry","category-artificial-intelligence","category-cms","category-medicare-advantage","tag-ai","tag-cms","tag-medicare-advantage","tag-medicare-advantage-prior-authorization","tag-older-adults"],"_links":{"self":[{"href":"https:\/\/medicarereport.org\/index.php?rest_route=\/wp\/v2\/posts\/22437","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medicarereport.org\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medicarereport.org\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/medicarereport.org\/index.php?rest_route=\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/medicarereport.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=22437"}],"version-history":[{"count":1,"href":"https:\/\/medicarereport.org\/index.php?rest_route=\/wp\/v2\/posts\/22437\/revisions"}],"predecessor-version":[{"id":22438,"href":"https:\/\/medicarereport.org\/index.php?rest_route=\/wp\/v2\/posts\/22437\/revisions\/22438"}],"wp:attachment":[{"href":"https:\/\/medicarereport.org\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=22437"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medicarereport.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=22437"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medicarereport.org\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=22437"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}