The Impact of AI and Prior Authorizations on Home Health and Hospice

AGG Talks: Home Health & Hospice

AGG Talks: Home Health & Hospice
The Impact of AI and Prior Authorizations on Home Health and Hospice
Mar 04, 2025 Season 1 Episode 9
Arnall Golden Gregory LLP

In this episode, AGG Healthcare attorneys Bill Dombi and Jason Bring discuss the role of managed care, artificial intelligence, and prior authorizations in home health and hospice. Bill and Jason examine a recent lawsuit filed against a major Medicare Advantage plan in the United States District Court for the District of Minnesota challenging the use of AI-driven claims reviews in Medicare Advantage coverage decisions. They also address concerns around prior authorization denials, their high reversal rates, and potential consequences for providers and patient care.