AGG Talks: Home Health & Hospice
Our podcast series features AGG attorneys and guests discussing business opportunities and legal issues for our friends in the home health and hospice industries. While we don’t provide care, we nevertheless consider ourselves part of the home health and hospice community. We enjoy sharing what we’ve learned after working with clients throughout the country, as well as giving our thoughts on new opportunities and challenges facing the industry, whether regulatory, reimbursement, compliance, or otherwise.
AGG Talks: Home Health & Hospice
The Impact of AI and Prior Authorizations on Home Health and Hospice
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Arnall Golden Gregory LLP
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Season 1
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Episode 9
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.