AI cannot be used to deny health care coverage, feds clarify to insurers
On Notice —
CMS worries AI could wrongfully deny care for those on Medicare Advantage plans.
Enlarge / A nursing home resident is pushed along a corridor by a nurse.
Health insurance companies cannot use algorithms or artificial intelligence to determine care or deny coverage to members on Medicare Advantage plans, the Centers for Medicare & Medicaid Services (CMS) clarified in a memo sent to all Medicare Advantage insurers.
The memo—formatted like an FAQ on Medicare Advantage (MA) plan rules...
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