On May 21, 2025, the Centers for Medicare and Medicaid Services (“CMS”) announced a significant expansion of its auditing efforts with respect to Medicare Advantage (“MA”) plans....more
SB 1120 (the “Bill”), which takes effect on January 1, 2025, amends existing California law to adopt guardrails around the use of artificial intelligence tools for the purpose of utilization management. As discussed in a...more
12/24/2024
/ Algorithms ,
Anti-Discrimination Policies ,
Artificial Intelligence ,
Audits ,
California ,
Centers for Medicare & Medicaid Services (CMS) ,
CMIA ,
Health Insurance ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Healthcare ,
Medical History ,
Medicare Advantage Organizations (MAOs) ,
New Legislation ,
Personal Information ,
Physicians ,
Policies and Procedures ,
Software
On Tuesday, January 16, 2024, Governor Kathy Hochul released the SFY 2025 New York State Executive Budget (“Executive Budget”). While still subject to legislative approval, the Executive Budget incorporates the recently...more
2/5/2024
/ Centers for Medicare & Medicaid Services (CMS) ,
Health and Essential Rights (HERO) Act ,
Healthcare ,
Insurance Industry ,
MCOs ,
Medicaid ,
Mental Health ,
New Amendments ,
New York ,
Social Security Act ,
State Budgets ,
Value-Based Payments ,
Waivers