CMS Proposes Rules to Ensure AI Does Not Impede Equitable Access to Services
Summary
On December 10, 2024, the Centers for Medicare & Medicaid Services (CMS) proposed to require Medicare Advantage (MA) organizations that use AI to ensure that such use is equitable. Specifically, the regulation would require MA organizations to “ensure services are provided equitably irrespective of delivery method or origin, whether from human or automated systems.” The proposed regulation explicitly states that if AI or automated systems are used, they “must be used in a manner that preserves equitable access to MA services.” CMS noted that compliance with the proposal could include limiting the impact of biased data inputs in AI, implementing a process to regularly ensure AI use is non-discriminatory and not using outputs with a known discriminatory bias. MA organizations are already prohibited from discriminating against enrollees based on their health status, and CMS does not expect that this proposed regulation would impose new burdens on MA organizations.
