Tag: Utilization Review

Regulations on AI in Health Insurance: Balancing Innovation and Clinical Authority

Explore how state legislatures are regulating AI in health insurance to maintain clinical authority and transparency in decision-making processes.

Aetna Medicare Advantage’s New Inpatient Payment Policy: Implications and Regulatory Concerns

Examining Aetna's new inpatient payment policy for Medicare Advantage plans, its conflicts with Medicare's Two-Midnight Rule, and implications for hospital reimbursement and compliance.