Morning Briefing
Summaries of health policy coverage from major news organizations
Coalition for Health AI Looks To Regulate AI Use In Medicaid Programs
Modern Healthcare: CHAI Releases AI Guidelines For State Medicaid Programs
States are grappling with how best to implement Medicaid work requirements under President Donald Trump’s tax law. Some could turn to artificial intelligence to more easily determine eligibility. In response, an industry group focused on AI standards for healthcare is looking to establish guardrails regarding the technology’s use. The Coalition for Health AI released two sets of best practice guidelines aimed at helping state agencies and developers, respectively, responsibly roll out tools and minimize coverage loss. (Famakinwa, 5/11)
Modern Healthcare: CMS' WISeR Model Sees Uneven Rollout On Prior Authorizations
The first use of prior authorization in fee-for-service Medicare is off to an uneven start, providers say. The Centers for Medicare and Medicaid Services launched the Wasteful and Inappropriate Service Reduction Model, or WISeR, in January. Under the six-year demonstration in six states, technology companies use tools such as artificial intelligence and machine learning to review prior authorization requests for services the agency deems “low-value,” including skin and tissue substitute grafts, electrical nerve stimulator implants, and knee arthroscopy for knee osteoarthritis. (Early, 5/11)
Stat: Rushed Medicaid Work Requirements Create A Lobbyist Scramble
Patient groups are jockeying for exemptions from Medicaid work requirements, but the unusually fast implementation timeline for states is causing headaches. (Wilkerson, 5/12)
Axios: Health Program Cuts Hit Home, Fueling Blame Game
Sweeping changes that congressional Republicans made to the Affordable Care Act and Medicaid are starting to take effect, fueling an election-year blame game over coverage losses. A rise in the uninsured rate will put more stress on the health system and ratchet up concerns about health costs in an election year where affordability is voters' biggest concern. (Sullivan, 5/12)
Modern Healthcare: How Providence, Ardent Health Are Preparing For Medicaid Cuts
Health systems always have operating margins top-of-mind, and potentially devastating Medicaid cuts are bringing a new sense of urgency to the task of improving balance sheets. They are trimming services, implementing efficiency initiatives and rethinking expansion strategies to keep expenses in check, while simultaneously making investments to attract patients and increase revenue. Executives are hoping the efforts will be enough to offset roughly $1 trillion in federal Medicaid funding cuts and other policy shifts under the tax bill President Donald Trump signed into law last year. (Hudson, 5/11)
Carolina Public Press: ‘Imperfections’ In NC Medicaid Bill May Cause Headaches, Require Fixes
After months of political jockeying, state lawmakers finally pushed through a bipartisan bill to fully fund Medicaid through the end of the current fiscal year. However, the legislative victory wasn’t without its “imperfections,” as NC Rep. Sarah Crawford, D-Wake, put it in an interview with Carolina Public Press. (Thomae, 5/9)
