CMS Medicare Advantage AI Rule — Human Oversight

Yes. CMS Medicare Advantage AI Rule addresses Human Oversight through 1 provision.

Does CMS Medicare Advantage AI Rule require Human Oversight?

United States • enforcing

Yes — 1 provision

This regulation imposes 3 specific requirements for Human Oversight across 1 provision:

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

Obligation:

enforcing

Effective:

Jan 1, 2024

Risk tier:

high-risk

Scope:

providers

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

Violation	Fine
Non-compliance	CMS enforcement; potential plan sanctions