Insurers Urged to ‘Look Carefully’ at AI Tools in Wake of New Rule
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May 03, 2024
On April 26, the Biden administration released a final rule which, in addition to strengthening the Affordable Care Act’s antidiscrimination protections, attempts to address rising concern about health insurers’ use of artificial intelligence, algorithms and other tools to make care and coverage decisions.
Managed care experts say that the new regulation — titled Nondiscrimination in Health Programs and Activities — likely won’t catch insurers off guard given the scrutiny they are already receiving about their use of AI. However, “they’re going to have to look carefully at their use of any kind of automated tools,” predicts Harvey Rochman, a litigation partner at Manatt, Phelps & Phillips, LLP. “There’ll be a large focus on the kinds of automated tools that plans can use in various aspects of their work, from claims to utilization management.”
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