EveryAILaw.comCMS Medicare Advantage AI Rule
Obligations Covered
Provisions (1)
Clinician Oversight Mandate #
Requirements
| Requirement | Details |
|---|---|
| No sole reliance | AI predictions cannot be sole basis for denying services |
| Clinician final say | Health professionals must have final decision authority |
| Source attributes | ONC HTI-1 requires 31 source attributes for predictive DSI |
Penalties
| Violation | Fine |
|---|---|
| Non-compliance | CMS enforcement; potential plan sanctions |