Bill proposes guardrails to stop AI-driven Medicare Advantage denials

A new bipartisan bill introduced in Congress aims to establish "sensible guardrails" on the use of artificial intelligence to make coverage denials in Medicare Advantage plans. The legislation responds to watchdog reports and Senate investigations finding MA plans using algorithms to deny post-acute and rehabilitation care at high rates. The bill would require transparency on the AI tools used, mandate human clinical review of algorithm-based denials, and prohibit automatic denials based solely on an AI prediction. While not yet law, the proposal signals growing federal scrutiny of automated MA denials. Monitor the bill's progress as the Senate Finance Committee continues its MA denial probe.