The administration's proposal aims to protect Medicare Advantage patients from providers backing out on previously approved claims for inpatient admissions, ensuring clarity in coverage criteria and appeal processes.
HHS highlights that although 80% of denied Medicare Advantage claims are successfully appealed, only 4% are actually contested, suggesting that many denied claims could be reversed if appealed.
To prevent bias in healthcare AI, the administration proposes measures to curb the use of flawed AI recommendations, which often disproportionately affect low-income and minority patients, exacerbating healthcare inequities.
AI systems trained on flawed demographic data can perpetuate injustices, as existing inequalities in electronic health records lead to skewed healthcare recommendations, impacting care for communities of color and low-income individuals.
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