When will the Centers for Medicare and Medicaid Services issue new regulatory guidance or proposed rule on the use of AI for prior authorization of medical care?

On April 4 2025, CMS published its final rule for the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicare Cost Plan Program, and Programs of All-Inclusive Care for the Elderly (CMS-4208-F). The final rule did not resolve the issue of the use of AI in prior authorization and the agency said it will put forth regulations related to AI in future rulemaking.

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