Tricia Beckmann Comments on CMS Rule Aimed at Defining Coverage Criteria, AI-Driven Tools

Faegre Drinker Consulting principal Tricia Beckmann provided insight into new rulemaking activity from the Centers for Medicare and Medicaid Services (CMS) as President Joe Biden closes out his term. 

The article noted that many industry experts say the administration’s last rulemaking attempt was largely “business as usual,” with CMS expanding on Biden’s policies and working on issues like utilization management, misleading marketing practices and provider directory accuracy. Some of these provisions – but not all – will be included in the final rule, which would be released by incoming President-elect Donald Trump’s administration. 

“It certainly seems like this was written as if there was going to be another Democratic administration, as the overall trend of CMS regulatory policymaking in the last four years,” Beckmann noted. “Some of the provisions are probably an overreach in so far as they don’t align with what we think is the posture of the Trump administration versus some areas that are potentially tricky.”

Beckmann added that policies on utilization management and insurers’ reported use of artificial intelligence to deny claims, have drawn criticism from both sides of the political aisle.