News & Analysis as of

Artificial Intelligence Health Insurance

Alston & Bird

New Maryland Law Regulates Use of AI in Health Care Utilization Management Reviews

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Our Health Care Group discusses what businesses need to know about a new law in Maryland that creates new requirements for health plans’ use of artificial intelligence in making coverage and treatment decisions....more

McGuireWoods LLP

The Fertility Economy: Where Science Meets Market Demand

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The fertility and reproductive health sectors are experiencing dynamic growth, driven by shifting demographics, evolving societal attitudes and rapid technological advancement. The global fertility market size is expected to...more

Troutman Pepper Locke

Colorado Division of Insurance Expands AI Governance and Framework Regulation to Private Passenger Auto and Health Benefit Plan...

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On August 20, 2025, the Colorado Division of Insurance (Division) amended Regulation 10-1-1 to expand its existing limited applicability to insurers offering individual life insurance to apply to insurers offering private...more

Williams Mullen

[Hybrid Event] 2025 Benefits Forum: Benefit Trends for a Resilient Workforce - September 25th, Richmond, VA

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Join Williams Mullen for our hybrid 2025 Benefits Forum, where our attorneys will examine how emerging trends and recent legislative developments have created new opportunities for employers to design benefits that meet the...more

Brownstein Hyatt Farber Schreck

Deja Vu? Colorado’s Special Session Ends with Budget Tweaks, But Again No Long-Term AI Deal

Last Thursday, Aug. 21, the Colorado General Assembly reconvened for its 2025 Extraordinary Session, mostly focused on addressing the $750‒$800 million state budget shortfall created by the federal government’s passage of the...more

Sheppard Mullin Richter & Hampton LLP

So You Want to Start a Concierge Medicine Practice? Here are Five Key Legal Considerations

With increased consolidation of traditional medical practices and declining reimbursement rates, many physicians are turning to alternative models like concierge medicine to preserve their independence. Concierge medicine...more

BakerHostetler

Texas Passes New Law Regulating Electronic Health Records and the Use of AI by Healthcare Professionals

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On June 20, Texas enacted S.B. 1188, joining only a handful of states that are taking artificial intelligence (AI) and data offshoring restrictions into their own hands. The law applies to most healthcare providers and all...more

Jones Day

Coming January 2026: CMS Launches AI Program to Screen Prior Authorization Requests for Treatments

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New CMS program, WISeR, will leverage third parties to screen prior authorization requests using technologically enhanced processes....more

Cooley LLP

Will AI Be Your New Doctor? Probably Not, Thanks to Recent Trends in State Regulation

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As the use of artificial intelligence (AI) becomes increasingly commonplace, some have raised concerns about its use in medicine, particularly when AI assumes a role that is traditionally held by a physician or other licensed...more

Benesch

Dental/DSO Intelligence Monthly Report: July 2025

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As government scrutiny of the healthcare industry intensifies, enforcement agencies are casting wider nets to recover funds based on narrowly interpreted violations. This puts not only healthcare providers but also those...more

Holland & Knight LLP

Holland & Knight Health Dose: July 29, 2025

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This week, the U.S. House of Representatives will be out of session, as the chamber has adjourned for the August 2025 district work period. The U.S. Senate remains in session and continues to consider nominations to lead...more

Stevens & Lee

New Changes to Medicare and Private Prior Authorization Processes

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Both the Centers for Medicare & Medicaid Services (CMS) and dozens of the nation’s largest insurance companies have revealed upcoming changes to their prior authorization processes. These changes aim to reduce the prevalence...more

Phelps Dunbar

Medicare’s New AI Payment Review Model: What Providers Need to Know

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CMS announced the rollout of the WISeR (Wasteful and Inappropriate Service Reduction) model in June. It aims to use technologies like artificial intelligence (AI) to “ensure timely and appropriate Medicare payment for select...more

Epstein Becker & Green

The First National Health Care Fraud Takedown of the Second Trump Administration: What Stayed the Same and What is New?

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On June 30, 2025, the U.S. Department of Justice (“DOJ”), together with the U.S. Department of Health and Human Services Office of Inspector General (“HHS OIG”) and other law enforcement partners, announced the results of the...more

Katten Muchin Rosenman LLP

CMS Unveils New Prior Authorization “WISeR Model” for Electrical Nerve Stimulators, Skin and Tissue Substitutes and Knee...

CMS recently announced a new model it will be using to pilot the use of artificial intelligence and machine learning in reviewing prior authorizations submitted for certain services CMS has identified as being at greater risk...more

Holland & Knight LLP

Upcoming Utilization Review Restrictions in Light of Emerging Artificial Intelligence

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With the rapid development of artificial intelligence (AI), state legislatures have been attempting to keep up with the technological advancing surge. Most recently, Texas enacted Senate Bill (SB) 815, a law imposing greater...more

Arnall Golden Gregory LLP

Locked Out: How a Federal Moratorium on AI Regulation Could Reshape Healthcare Oversight

On May 22, 2025, the U.S. House of Representatives passed the “One Big Beautiful Bill Act” (H.R. 1) by a vote of 215-214, which includes a significant provision imposing a 10-year moratorium on state and local regulation of...more

Hogan Lovells

AI Summit panelists offer tips for obtaining reimbursement for innovative health care technology

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Hogan Lovells and the AI Health Care Coalition recently hosted their fourth annual AI Health Law & Policy Summit, where thought leaders and policymakers gathered to discuss a variety of topics including reimbursement issues...more

Offit Kurman

CareYaya: A Revolutionary Approach to Elder Care

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In this episode of the Sandwich Generation Survival Guide, host Candace Dellacona is joined by Neal Shah and Sydney Rosbury from CareYaya, an innovative platform transforming the elder care industry. Neal shares his journey...more

Health Care Compliance Association (HCCA)

Top Healthcare Compliance Priorities for 2025

Recently Protiviti released an intriguing report: Top Compliance Priorities for U.S. Healthcare Organizations in 2025. In this podcast their Global Healthcare Compliance Leader, Leyla Erkan, CHC, CHP, CHRC, shares some of the...more

Morgan Lewis

(AI)n’t Done Yet: States Continue to Craft Rules to Manage AI Tools in Healthcare

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As the regulation of artificial intelligence (AI) tools in healthcare settings rapidly evolves, state medical boards and related agencies are at the forefront of development and enforcement. While some states have taken...more

Hogan Lovells

AI Health Law & Policy: Remote patient monitoring reimbursement & coding concerns

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Remote patient monitoring (RPM) (oftentimes incorporating artificial intelligence (AI) to analyze data) uses technology to track a patient's physiologic data, such as vital signs, medication adherence, and activity levels,...more

The Volkov Law Group

DOJ Adopts Aggressive Stance Against Algorithmic Coordination in Multiplan Antitrust Filing

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Recently, the Antitrust Division of the United States Department of Justice submitted a Statement of Interest in In re: Multiplan Health Insurance Provider Litigation, a class action presently pending before the United States...more

Ropes & Gray LLP

Key Trends in Dual-Eligible Health Insurance: Takeaways from the Medicarians Conference

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Attorneys from Ropes & Gray attended the Medicarians Conference from March 31 to April 2, a premier event for Medicare Advantage (MA) and other health insurance brokers, agents, and distribution arms, as well as regional and...more

Maynard Nexsen

NAIC Spring Meeting Update Part Two

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As discussed in last week’s article, along with almost 3,000 regulators and insurance industry leaders, the Maynard Nexsen Insurance Regulatory team of attorneys attended the National Association of Insurance Commissioners...more

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