Protecting Patients from Automated Denials Act establishes requirements for using artificial intelligence in Medicare Advantage prior authorization.

The Protecting Patients from Automated Denials Act amends title XVIII of the Social Security Act to establish requirements for the use of artificial intelligence in prior authorization denials by Medicare Advantage organizations. It prohibits denials based solely on artificial intelligence unless reviewed and approved by a qualified physician reviewer. The act mandates that plans provide providers with opportunities to discuss denials and disclose the use of artificial intelligence.

Protecting Patients from Automated Denials Act establishes requirements for using artificial intelligence in Medicare Advantage prior authorization.

The Protecting Patients from Automated Denials Act amends title XVIII of the Social Security Act to establish requirements for the use of artificial intelligence in prior authorization denials by Medicare Advantage organizations. It prohibits denials based solely on artificial intelligence unless reviewed and approved by a qualified physician reviewer. The act mandates that plans provide providers with opportunities to discuss denials and disclose the use of artificial intelligence.