“On October 22, 2019, the Centers for Medicare and Medicaid Services (‘CMS’) issued a Request for Information (‘RFI’) to obtain input on how CMS can utilize Artificial Intelligence (‘AI’) and other new technologies to improve its operations. CMS’ objectives to leverage AI chiefly include identifying and preventing fraud, waste, and abuse. The RFI specifically states CMS’ aim ‘to ensure proper claims payment, reduce provider burden, and overall, conduct program integrity activities in a more efficient manner.’ The RFI follows last month’s White House Summit on Artificial Intelligence in Government, where over 175 government leaders and industry experts gathered to discuss how the Federal government can adopt AI ‘to achieve its mission and improve services to the American people…’”
“In the RFI, CMS poses many questions to AI vendors, healthcare providers and suppliers that likely would be addressed by regulation. Before the Federal government relies on AI to detect fraud, CMS must gain assurances that AI technologies will not return inaccurate or incorrect outputs that could negatively impact providers and patients. One key question raised involves how to assess the effectiveness of AI technology and how to measure and maintain its accuracy. The answer to this question should factor heavily into the risk calculation of CMS using AI in its fraud detection activities…”
“In addition to fraud detection, the RFI is seeking advice as to whether new technology could help CMS identify ‘potentially problematic affiliations’ in terms of business ownership and registration. Similarly, CMS is interested to gain feedback on whether AI and machine learning could speed up current expensive and time-consuming Medicare claim review processes and Medicare Advantage audits.” Read the full article here.
Source: CMS’s Request for Information Provides Additional Signal That AI Will Revolutionize Healthcare – October 28, 2019. National Law Forum.
