CMS Issues AI Guidance for Medicare Advantage Plans

CMS: MA insurers can’t use AI, algorithms to deny care.

The CMS sent a memo clarifying that Medicare Advantage insurers are not allowed to use algorithms or AI-powered tools as the basis for denying care or coverage. Algorithms and AI tools can be used only to support coverage decisions, and insurers must ensure that the tools they are using comply with the CMS’ coverage decision requirements, the agency said.

Full Story: Becker’s Payer Issues (2/8), Ars Technica (2/9)